Adult ambulatory care visits to nurses and physicians: methodological limitations of the medical expenditure panel survey data.

The 1997 Medical Expenditure Panel Survey (MEPS) data report that approximately 80 million adult ambulatory visits are made to nursing personnel. Adults who visit nursing personnel and who visit physicians are similar with regard to sex and income. As compared to nursing personnel, physician visits are longer and more likely to involve diagnosis or treatment. Older adult visits (ages 65 to 90) to nursing personnel are significantly longer than the visits of younger adults. As compared to physician visits, nursing personnel visits are significantly more likely to be characterized as "other" for all adults and especially for older adults. Although these findings suggest important differences between physician and nurse ambulatory care visits, the undifferentiated use of the term nurse and the significant percentage of uncharacterized visits to nursing personnel signal serious deficiencies in the MEPS data in exploring nonphysician ambulatory care.