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Supplier kind and administration of widespread visits in main care.
Am J Manag Care. 2017 Apr;23(four):225-231
Authors: Roblin DW, Liu H, Cromwell LF, Robbins M, Robinson BE, Auerbach D, Mehrotra A
Summary
OBJECTIVES: Debate continues on whether or not nurse practitioners (NPs) and doctor assistants (PAs) usually tend to order ancillary providers, or order extra expensive providers amongst options, than main care physicians (PCPs). We in contrast prescription medicine and diagnostic service orders related to NP/PA versus PCP visits for administration of neck or again (N/B) ache or acute respiratory an infection (ARI).
STUDY DESIGN: Retrospective, observational examine of visits from January 2006 by March 2008 within the grownup main care apply of Kaiser Permanente in Atlanta, Georgia.
METHODS: Knowledge had been obtained from digital well being information. NP/PA and PCP visits for N/B ache or ARI had been propensity rating matched on affected person age, gender, and comorbidities.
RESULTS: On propensity score-matched N/B ache visits (n = 6724), NP/PAs had been much less seemingly than PCPs to order a computed tomography (CT)/magnetic resonance picture (MRI) scan (2.1% vs three.three%, respectively) or narcotic analgesic (26.9% vs 28.5%) and extra prone to order a nonnarcotic analgesic (13.5% vs eight.5%) or muscle relaxant (45.eight% vs 42.5%) (all P ?.05). On propensity score-matched ARI visits (n = 24,190), NP/PAs had been extra seemingly than PCPs to order any antibiotic medicine (73.7% vs 65.eight%), however much less prone to order an x-ray (6.three% vs eight.6%), broad-spectrum antibiotic (41.5% vs 42.5%), or speedy strep take a look at (6.three% vs 9.7%) (all P ?.05).
CONCLUSIONS: Within the multidisciplinary main care apply of this well being upkeep group, NP/PAs attending visits for N/B ache or ARI had been much less seemingly than PCPs to order superior diagnostic radiology imaging providers, to prescribe narcotic analgesics, and/or to prescribe broad-spectrum antibiotics.
PMID: 28554207 [PubMed – indexed for MEDLINE]