J Ambul Care Manage. 2009 Jul-Sep;32(3):216-25.

Ambulatory specialist use by nonhospitalized patients in us health plans: correlates and consequences.

Starfield B, Chang HY, Lemke KW, Weiner JP.

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Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. bstarfie@jhspb.edu

Abstract

Approximately 7 of 10 (and 95% of the elderly) people in US health plans see one or more specialists in a year. Controlling for extent of morbidity, discontinuity of primary care physician visits is associated with seeing more different specialists. Having a general internist as the primary care physician is associated with more different specialists seen. Controlling for differences in the degree of morbidity, receiving care from multiple specialists is associated with higher costs, more procedures, and more medications, independent of the number of visits and age of the patient.

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