Volume 47 | Number 4 | August 2012

Abstract List

Louis Vernacchio, Jennifer M. Muto, Gregory Young, Wanessa Risko


To determine patterns of subspecialty utilization within a pediatric primary care network.

Data Sources/Study Setting

Paid claims from a large not‐for‐profit health plan for patients of he ediatric hysicians' rganization at hildren's, a network of private pediatric practices affiliated with hildren's ospital oston.

Principal Findings

The subspecialty visit rate was 1.01 visits per subject‐year. In 2007, 56.8 percent of subjects had no subspecialty visits, whereas 4.2 percent had ≥5 visits; the corresponding figures in 2008 were 54.1 and 4.5 percent, respectively. The most frequently visited subspecialties were phthalmology, rthopedics, ermatology, torhinolaryngology, and llergy/mmunology. Visit rates varied sevenfold by practice.


Wide practice variability in pediatric subspecialty utilization suggests an opportunity for reducing unnecessary visits. Better integration between primary care and the most commonly used subspecialties will be needed to meaningfully reduce unnecessary visits and enhance value.