How the National Ambulatory Medical Care Survey has been used to identify health disparities in the care of patients in the United States

Amanda S Weissman; Varun Ranpariya; Alan B Fleischer Jr; Steven R Feldman

doi:10.1016/j.jnma.2021.03.007

How the National Ambulatory Medical Care Survey has been used to identify health disparities in the care of patients in the United States

J Natl Med Assoc. 2021 Oct;113(5):504-514. doi: 10.1016/j.jnma.2021.03.007. Epub 2021 Apr 18.

Authors

Amanda S Weissman¹, Varun Ranpariya², Alan B Fleischer Jr³, Steven R Feldman⁴

Affiliations

¹ Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. Electronic address: a.weissman44@gmail.com.
² Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
³ Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
⁴ Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA; Department of Dermatology, University of Southern Denmark, Odense, Denmark.

PMID: 33879357
DOI: 10.1016/j.jnma.2021.03.007

Abstract

Background: Healthcare disparities negatively impact patient health outcomes; addressing disparities could improve quality of life and decrease overall healthcare cost. The National Ambulatory Medical Care Survey (NAMCS) is an objective and reliable source for collecting information on United States (U.S.) ambulatory medical care service visits and may be a useful tool for identifying potential disparities in care.

Objective: The purpose of this literature review is to describe studies utilizing NAMCS to capture U.S. healthcare disparities.

Methods: PubMed was searched for scientific articles that utilized NAMCS to determine health disparities in the U.S. The keywords queried included "NAMCS" or "National Ambulatory Medical Care Survey" and "disparity" or "disparities" as a pair or additionally paired with one of the following: "race", "ethnicity", "age", "gender", "geography", or "insurance".

Results: 66 studies were found that incorporated NAMCS data from 1980-2016 into their methods to measure outcomes relating to health disparities. Disparities were found in the following categories: race/ethnicity, geographic location, age, insurance type, gender, specialist care versus primary care, body habitus, and preexisting conditions affecting patient outcomes. Disparities were identified in pain management, neurology, dermatology, psychiatry, patient communication access, and non-specialty specific or primary care visits related to disease conditions, screening, and treatment plans.

Limitations: Only PubMed was utilized as a search engine and may not encompass all studies on NAMCS and health disparities. NAMCS is a cross-sectional database and does not allow for longitudinal analyses.

Conclusions: NAMCS may be an underused tool given the limited number of articles that identify health disparities using it. Research studies utilizing NAMCS may identify potential disparities ultimately leading to better healthcare outcomes.

Keywords: Disparities; Disparity; Health disparities; NAMCS; National Ambulatory Medical Care Survey.

Publication types

Review

MeSH terms

Ethnicity
Health Care Surveys
Healthcare Disparities*
Humans
Primary Health Care
Quality of Life*
United States