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Res Gerontol Nurs. 2012 Jul;5(3):163-73. doi: 10.3928/19404921-20120605-01. Epub 2012 Jun 15.

Factors associated with the use of advanced practice nurses/physician assistants in a fee-for-service nursing home practice: a comparison with primary care physicians.

Author information

1
Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA. debra.bakerjian@ucdmc.ucd.edu

Abstract

The purpose of this research was to examine factors associated with the use of advanced practice nurse and physician assistant (APN/PA) visits to nursing home (NH) patients compared with those by primary care physicians (PCPs). This was a secondary analysis using Medicare claims data. General estimation equations were used to determine the odds of NH residents receiving APN/PA visits. Ordinary least squares analyses were used to examine factors associated with these visits. A total of 5,436 APN/PAs provided care to 27% of 129,812 residents and were responsible for 16% of the 1.1 million Medicare NH fee-for-service visits in 2004. APN/PAs made an average of 33 visits annually compared with PCPs (21 visits). Neuropsychiatric and acute diagnoses and patients with a long-stay status were associated with more APN/PA visits. APN/PAs provide a substantial amount of care, but regional variations occur, and Medicare regulations constrain the ability of APN/PAs to substitute for physician visits.

PMID:
22716651
DOI:
10.3928/19404921-20120605-01
[Indexed for MEDLINE]

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