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Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care
dc.contributor.authorLiu, Chuan‐fen
dc.contributor.authorHebert, Paul L.
dc.contributor.authorDouglas, Jamie H.
dc.contributor.authorNeely, Emily L.
dc.contributor.authorSulc, Christine A.
dc.contributor.authorReddy, Ashok
dc.contributor.authorSales, Anne E.
dc.contributor.authorWong, Edwin S.
dc.date.accessioned2020-04-02T18:38:42Z
dc.date.availableWITHHELD_13_MONTHS
dc.date.available2020-04-02T18:38:42Z
dc.date.issued2020-04
dc.identifier.citationLiu, Chuan‐fen ; Hebert, Paul L.; Douglas, Jamie H.; Neely, Emily L.; Sulc, Christine A.; Reddy, Ashok; Sales, Anne E.; Wong, Edwin S. (2020). "Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care." Health Services Research 55(2): 178-189.
dc.identifier.issn0017-9124
dc.identifier.issn1475-6773
dc.identifier.urihttps://hdl.handle.net/2027.42/154625
dc.description.abstractObjectiveTo examine whether nurse practitioner (NP)- assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)- assigned patients.Data SourcesVeterans Affairs (VA) administrative data capturing characteristics, outcomes, and provider assignments of 806 434 VA patients assigned to an MD primary care provider (PCP) who left VA practice between 2010 and 2012.Study DesignWe applied a difference- in- difference approach comparing outcomes between patients reassigned to MD and NP PCPs, respectively. We examined measures of outpatient (primary care, specialty care, and mental health) and inpatient (total and ambulatory care sensitive hospitalizations) utilization, costs (outpatient, inpatient and total), and clinical outcomes (control of hemoglobin A1c, LDL, and blood pressure) in the year following reassignment.Principal FindingsCompared to MD- assigned patients, NP- assigned patients were less likely to use primary care and specialty care services and incurred fewer total and ambulatory care sensitive hospitalizations. Differences in costs, clinical outcomes, and receipt of diagnostic tests between groups were not statistically significant.ConclusionsPatients reassigned to NPs experienced similar outcomes and incurred less utilization at comparable cost relative to MD patients. NPs may offer a cost- effective approach to addressing anticipated shortages of primary care physicians.
dc.publisherRAND Corporation
dc.publisherWiley Periodicals, Inc.
dc.subject.otherutilization
dc.subject.othernurse practitioner
dc.subject.otherprimary care
dc.subject.otherhealth workforce
dc.subject.othercost
dc.subject.otherquality of care
dc.titleOutcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPublic Health
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/154625/1/hesr13246_am.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/154625/2/hesr13246-sup-0001-Authormatrix.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/154625/3/hesr13246.pdf
dc.identifier.doi10.1111/1475-6773.13246
dc.identifier.sourceHealth Services Research
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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