Content of Ambulatory Internal Medicine Practice in an Academic Army Medical Center and an Army Community Hospital

We evaluated the content of care in an internal medicine clinic of an academic Army medical center and an Army community hospital. Results were compared to The National Ambulatory Medical Care Survey (NAMCS) and to university internal medicine clinic data. The patient population of the Army medical center was demographically more similar to that of NAMCS than was the university population. Frequency of referral in the Army medical center was more like that of the university, and in both institutions patients with more chronic than acute problems were seen as compared to NAMCS. In addition, a higher proportion of patients at the Army medical center had common diagnoses such as hypertension, diabetes, or osteoarthritis compared to NAMCS. The patient population at the Army community hospital was considerably younger and consisted of more men and non-whites than in NAMCS. Differences in diagnoses were largely explainable by the demographic differences.