United Hospital Fund Research Documents Growth in Ambulatory Care in New York City | Archived

Hospital Watch Data Suggest a High Level of Price Sensitivity That May Affect the Availability of Ambulatory Services

Release Date: 03.25.2008
Contact: rdeluna@uhfnyc.org
Contact Phone: 212-494-0733

Between 1995 and 2004, ambulatory care visits to hospital clinics and independent diagnostic and treatment centers grew by 31 percent—from 8.8 million to 11.5 million visits (compared with 5.5 percent growth in inpatient discharges over the same period). This growth, however, was not experienced uniformly across institutional settings, and differences in rates of reimbursement appear to play a role in hospital clinics.

These are among the findings from the latest issue of Hospital Watch, a publication of the United Hospital Fund that focuses on hospital finance and utilization issues.

Report findings include:

• While the volume of visits to independent diagnostic and treatment centers grew by 121 percent (from 1.1 million to 2.3 million visits) over the study period, hospital clinics still provide about 80 percent of clinic visit care in the city.

• A small number of hospitals (17) provided over 70 percent of hospital-based clinic visits in 2004.

• Among hospital-based clinics, the vast majority of visits take place in facilities that receive enhanced Medicaid rates; these facilities experienced disproportionately large growth in clinic visits over the study period.

“Many of our city's low-income residents have long relied on institutional providers for their routine ambulatory care, and this study suggests that that dependence grew between 1995 and 2004,” says Jim Tallon, president of the United Hospital Fund. “This shouldn't be surprising since expanding primary care services to these vulnerable populations was a major focus of the city and state in the mid '90s.

“But with many of our city's institutional providers of clinic care facing continuing financial pressures, it's important that we continue to monitor utilization of these services to ensure access to care for low-income New Yorkers. For example, clinic visit volume peaked in 2002. It's possible that patient volume shifted to physicians' offices in the following two years, or we may be identifying the first evidence of new access problems.”

The full report is available.

About the United Hospital Fund: The United Hospital Fund is a health services research and philanthropic organization whose mission is to shape positive change in health care for the people of New York. ###