Ambulatory Visits

Hospital Discharges


Annual population estimatea

% (se)

Annual population estimatea

% (se)

Main payment source



61.7 (3.7)


59.7 (2.0)



6.4 (1.8)


30.6 (1.6)



6.6 (1.9)


2.7 (0.5)



25.3 (3.4)


6.9 (1.7)

Site of cared

Specialty setting


46.1 (3.8)


58.5 (7.2)

Non-specialty setting


53.9 (3.8)


41.4 (7.3)

NOTE: n = sample size; % = percent distribution; se = standard error.

aAnnual estimates for the number of ambulatory care visits are based on a 5-year average (1995-1999). A total of 528 cases from NAMCS and NHAMCS were weighted to obtain population estimates. A total of 4,430 cases from HCUP, 1997, were weighted to obtain an annual estimate for hospital care. Numbers may not add to total because of rounding errors.

bValues are missing for 22.6% of cases for hospital discharges.

cAn estimated 7% of the “other/unknown” category are insured by Medicare. Other sources of insurance include the military.

dFor ambulatory care, specialty setting is a hospital outpatient department, and non specialty setting is a physician’s office. For hospital care, a specialty setting is an urban teaching hospital and non-specialty setting is a rural or urban non teaching hospital.

SOURCES: National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), 1995-1999; Healthcare Cost and Utilization Project (HCUP), 1997; special tabulations, NCPB staff.

Oncology Social Workers (APOSW) (June McAtee, APOSW Membership Chair, personal communication to Maria Hewitt, March 21, 2003).

Pediatric cancer care is usually delivered through academic centers involved in research (Wittes, 2003). Roughly 50 to 60 percent of all children and adolescents newly diagnosed with cancer in the United States are enrolled on clinical trials (Murphy, 2002; Shochat et al., 2001). This is quite remarkable, given that fewer than 5 percent of adults newly diagnosed with cancer are enrolled in trials. Clinical trials establish standards for an appropriate diagnostic workup, review of pathology, surgical approach, radiotherapy, and chemotherapy administration, as well as therapeutic efficacy and toxicity. Peer-reviewed treatment plans have provided standards of

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