Size and age-sex distribution of pediatric practice - A study from Pediatric Research in Office Settings

Objectives: To estimate (1) the average number of patients per practitioner in Pediatric Research in Office Settings, the national practice-based rese arch network of the American Academy of Pediatrics; (2) the total number of active patients cared for in the network; and (3) the age-sex distribution of patients seen in pediatric practice. Setting: Eighty-nine practices in 31 states with 373 Pediatric Research in Office Settings practitioners (59% of Pediatric Research in Office Settings ,members). Methods: Practices were asked to enumerate the number of patients visiting the practice during the 2-year period from January 1, 1991, through Decembe r 31, 1992. Patients making multiple visits were counted only once, resulti ng in a patient count rather than a visit count. Age-sex registers were com pleted using computer billing records or medical record sampling. Results: Study participants cared for 529 513 active patients (50.7% male). Each practitioner cared for an average of 1546 patients. The number of pat ients per practitioner was significantly higher in less-populated areas and in solo practices. Children aged 12 years and younger comprised 81% of the patients seen by Pediatric Research in Office Settings practitioners, and more than half of the children were aged 6 years or younger. Before age 5 y ears, boys accounted for a slightly, but significantly, higher number of pa tients, whereas after age 14 years, girls comprised a significantly larger proportion of patients. Conclusions: The average number of 1546 patients per practitioner derived f rom these private practice data is in line with health maintenance organiza tion-based estimates. Pediatric practitioners predominantly serve younger c hildren. These data provide the only current national estimates of the size and age-sex distribution of independent pediatric practices, and can help pediatricians and health service researchers plan for the future provision of health care to children.