|
|||||
|
|
Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000–2010 |
|
| Authors: | Orna Intrator Ph.D. Edward Alan Miller Ph.D. M.P.A. Emily Gadbois M.S. M.A. Joseph Kofi Acquah M.A. Rajesh Makineni M.Sc. Denise Tyler Ph.D. |
| Affiliation: | 1. Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY;2. Canandaigua VA Medical Center, Canandaigua, NY;3. Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI;4. Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA;5. Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI;6. Department of Gerontology, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA;7. Department of Economics, Brown University, Providence, RI;8. ProvidenceVA Medical Center, Providence, RI |
| Abstract: | ObjectiveTo examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000–2010.Data SourcesData were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample).MethodsNP/PA state average employment, visit per bed year (VPBY), and providers per NH were examined. State fixed‐effect models examined the association between state regulations and NP/PA use.Principal FindingsNHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000–2010. Average NP/PA VPBY increased from 1.0/0.3 to 3.0/0.6 during 2000–2010. Average number of NPs/PAs per NH increased from 0.2/0.09 to 0.5/0.14 during 2000–2010. The impact of state scope‐of‐practice regulations was mixed.ConclusionsNP and PA scope‐of‐practice regulations impact their practice in NHs, not always as intended. |
| Keywords: | Medicare claims Online Survey Certification and Reporting (OSCAR) system scope‐of‐practice physician visits in nursing homes organization of medical staff |