Patient mix in the primary ambulatory care clinics of an academic medical center

BACKGROUND: The authors wished to learn whether the primary ambulatory care clinics of a university hospital had a sufficiently diverse patient mix for training in common medical problems. METHOD: Claims data for all the ambulatory care clinics at the University of Illinois Hospital from June 1989 through June 1990 were examined for principal diagnoses. The diagnoses were grouped into common ambulatory care diagnosis clusters. The frequencies of the clusters were compared with the national frequencies from the National Ambulatory Medical Care Survey of 1989. RESULTS: Only eight of 25 leading clusters nationally were seen with frequencies greater than 1% in the hospital's primary care clinics (i.e., family practice, general internal medicine, general pediatrics). This number increased to 22 when the clinics of other specialties were included. CONCLUSION: To create an appropriate patient mix for training medical students and residents in ambulatory care, the university hospital examined in this study could supplement the use of its primary care clinics with the use of clinics in other specialties. This may be a less expensive and administratively less complex alternative to using off-campus private practices for such training.