The Contribution of Physicians, Physician Assistants, and Nurse Practitioners Toward Rural Primary Care
Findings From a 13-State Survey
Bibliographic Data
| ID | 9103016 |
|---|---|
| Authors | Mark P Doescher (0000-0003-1631-0428, University of Oklahoma Health Sciences Center, corresponding author), C Holly A Andrilla (0000-0001-9678-7933, University of Washington), Susan M Skillman (0000-0001-8191-6771, University of Washington), Perri Morgan (0000-0001-9320-8182, Duke Medical Center), Louise Kaplan (0000-0001-7835-4675, Saint Martin's University) |
| Year | 2014 |
| Volume | 52 |
| Issue | 6 |
| Pages | 549-556 |
| Publication date | 2014-06-01 |
| Peer Reviewed | Yes |
| 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.0000000000000135 |
| PMID | 24824539 |
| OpenAlex | W2014985994 |
| Language | EN |
| Citations received | 6 |
| References cited | 7 |
BACKGROUND: Estimates of the relative contributions of physicians, physician assistants (PAs), and nurse practitioners (NPs) toward rural primary care are needed to inform workforce planning activities aimed at reducing rural primary shortages. OBJECTIVES: For each provider group, this study quantifies the average weekly number of outpatient primary care visits and the types of services provided within and beyond the outpatient setting. METHODS: A randomly drawn sample of 788 physicians, 601 PAs, and 918 NPs with rural addresses in 13 US states responded to a mailed questionnaire that measured reported weekly outpatient visits and scope of services provided within and beyond the outpatient setting. Analysis of variance and χ(2) testing were used to test for bivariate associations. Multivariate regression was used to model average weekly outpatient volume adjusting for provider sociodemographics and geographical location. RESULTS: Compared with physicians, average weekly outpatient visit quantity was 8% lower for PAs and 25% lower for NPs (P<0.001). After multivariate adjustment, this gap became negligible for PAs (P=0.56) and decreased to 10% for NPs (P<0.001). Compared with PAs and NPs, primary care physicians were more likely to provide services beyond the outpatient setting, including hospital care, emergency care, childbirth attending deliveries, and after-hours call coverage (all P<0.001). CONCLUSIONS: Although our findings suggest that a greater reliance on PAs and NPs in rural primary settings would have a minor impact on outpatient practice volume, this shift might reduce the availability of services that have more often been traditionally provided by rural primary care physicians beyond the outpatient clinic setting
Ambulatory care · Economic shortage · Emergency department · Family medicine · Health care · Multivariate analysis · Nurse practitioners · Outpatient clinic · Physician assistants · Primary care · Test (biology) · Workforce · Global Health Workforce Issues · Internal Medicine · Medicine · Nursing · Nursing Roles and Practices · Primary Care and Health Outcomes
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| Unique citing works | 6 |
|---|---|
| Citations per year | 0,55 |
| Citation span | 2015 - 2023 (9) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 6 |