Nurse Practitioner Practice Environments in Primary Care and Quality of Care for Chronic Diseases
Bibliographic Data
| ID | 9098083 |
|---|---|
| Authors | Lusine Poghosyan (0000-0002-0529-8171, Columbia University School of Nursing, New York, NY, corresponding author), Allison A Norful (0000-0002-6202-058X, Columbia University School of Nursing, New York, NY, corresponding author), Jianfang Liu (0000-0002-9235-3166, Columbia University School of Nursing, New York, NY, corresponding author), Mark W Friedberg (0000-0002-7907-8358, RAND Boston, Boston, MA) |
| Year | 2018 |
| Volume | 56 |
| Issue | 9 |
| Pages | 791-797 |
| Publication date | 2018-09-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000961 |
| PMID | 30015724 |
| OpenAlex | W2883714663 |
| Language | EN |
| Citations received | 3 |
| References cited | 31 |
BACKGROUND: The chronic disease burden in the United States represents a significant challenge for the primary care system. The nurse practitioner (NP) workforce can help meet the demand for care; however, organizational barriers such as poor practice environments prevent NPs from delivering high quality care. OBJECTIVES: We investigated the relationship between NP practice environments and quality of care for chronic diseases. RESEARCH DESIGN: We fit regression models to assess cross-sectional associations between claims-based quality measure performance and survey data on NP practice environments in Massachusetts. SUBJECTS: We used survey data from 221 primary care NPs from 118 practices. We obtained quality of care data for patients with asthma, diabetes, and cardiovascular disease. MEASURES: The Nurse Practitioner Primary Care Organizational Climate Questionnaire was used to measure practice environments with its following 4 subscales: NP-Physician Relations, Independent Practice and Support, Professional Visibility, and NP-Administration Relations. Three Healthcare Effectiveness Data and Information Set measures were used to evaluate the quality of care. RESULTS: A 1-SD increase in the organizational-level NP-Administration Relations subscale score was associated with a near doubling of the odds of receiving medication management for asthma. A 1-SD increase in the organizational-level Independent Practice and Support subscale score was associated with a 60% increase in the odds of receiving recommended screening for cardiovascular disease. There was no impact on diabetes care measure. CONCLUSIONS: NP practice environment affected the quality of care for 2 chronic conditions. Efforts should be implemented to improve NP practice environment to potentially improve care quality
Asthma · Chronic care · Cross-sectional study · Disease · Disease management · Family medicine · Health care · Logistic regression · MEDLINE · Odds · Odds ratio · Primary care · Quality (philosophy) · Survey data collection · Workforce · Diabetes Management and Education · Internal Medicine · Medicine · Nursing · Nursing Roles and Practices · Primary Care and Health Outcomes
Evaluating the Quality of Medical Care
Evaluating the Quality of Medical Care
The Quality of Health Care Delivered to Adults in the United States
Multiple Chronic Conditions Among US Adults
Response rate and measurement differences in mixed-mode surveys using mail, telephone, interactive voice response (IVR) and the Internet
Potentially Preventable Hospitalizations in Medicare Patients With Diabetes
Role of Geography and Nurse Practitioner Scope-of-Practice in Efforts to Expand Primary Care System Capacity
| Citations per year | 1 |
|---|---|
| Citation span | 2023 - 2026 (4) |
| Highly cited | No |