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Supplier kind and administration of frequent visits in major 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 pricey providers amongst options, than major care physicians (PCPs). We in contrast prescription treatment 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 research of visits from January 2006 by March 2008 within the grownup major care observe of Kaiser Permanente in Atlanta, Georgia.
METHODS: Information had been obtained from digital well being data. 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 probably 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 more likely 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 probably than PCPs to order any antibiotic treatment (73.7% vs 65.eight%), however much less more likely 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 major care observe of this well being upkeep group, NP/PAs attending visits for N/B ache or ARI had been much less probably 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]