Utilization of Health Services in Physician Offices and Outpatient Clinics by Adolescents and Young Women in the United States: Implications for Improving Access to Reproductive Health Services

PurposeWe examined utilization patterns of adolescents and young women as they seek general and reproductive health services in physician offices and hospital outpatient clinics.MethodsWe analyzed physician office visits in the 2003–2006 National Ambulatory Medical Care Surveys, and hospital outpatient clinic visits in the National Hospital Ambulatory Medical Care Surveys, to examine utilization patterns of females aged 9–26 years by 2-year age intervals and other characteristics such as physician specialty or clinic type.ResultsThe number of visits to primary care physician offices increased with age, from 4.9 million for ages 9–10 years to 9.0 million for ages 25–26 years. The proportion of visits made to obstetrician-gynecologists and family practitioners increased with age, and by ages 15–16 years fewer than half of all visits to primary care providers were made to pediatricians. The proportion of visits to family practitioners increased from 25% at ages 9–10 years to 30% at ages 25–26 years. By ages 17–18 years, a larger proportion of visits were made to obstetrician-gynecologists (33% of 7.0 million visits) and to family practitioners (34%) than to pediatricians (23%). The proportion of visits for reproductive health services peaked at 53% of 7.5 million physician visits at ages 20–21 years. Similar utilization patterns were observed for the 11.0 million hospital outpatient visits to primary care providers.ConclusionsBecause adolescents and young women most commonly utilize healthcare services provided by obstetrician-gynecologists and family practitioners, these specialties should be priority targets for interventions to improve the quality and availability of reproductive health services.