Recent guidelines for adolescent primary care call for the specification of clinical services by three adolescent age subgroups.

Yet analyses of office visits have either merged adolescence into one stage or divided it at age 15 years.

Objective

To explore the utilization of physician offices in the United States by early (11-14 years), middle (15-17 years), and late (18-21 years) adolescents.

Design

Secondary analysis of the 1994 National Ambulatory Medical Care Survey, focusing on visits made by the three adolescent age groups.

Setting

Nationally representative sample of 2426 physicians in nonfederal, nonhospital offices.

Subjects

A total of 33 598 visits by patients of all ages, representing 681.5 million visits in 1994.

Main Outcome Measures

Number of visits, health insurance, providers seen, duration of visits, reasons for visits, resulting diagnoses, and counseling provided.

Results

Adolescents aged 11 to 21 years made 9.1% (61.8 million) of the total office visits and represented 15.4% of the total US population in 1994.

This underrepresentation in visits held across all three adolescent age subgroups.

Within the adolescent cohort, whites were overrepresented relative to their population proportion (78.5% of visits, 67.6% of population) and blacks and Hispanic adolescents were underrepresented (8.3% and 9.3% of visits, 15.5% and 13.1% of population).

Middle adolescence signaled a life turning point from male to female predominance in office visits. (...)