Hendrix and Colleagues Publish Article in Health Affairs

Hendrix and Colleagues Publish Article in Health Affairs

Cristina Hendrix, associate professor, recently published an article entitled "Impact Of Physicians, Nurse Practitioners, And Physician Assistants On Utilization And Costs For Complex Patients" in Health Affairs. Co-authors include Perri Morgan of Duke University School of Medicine, Valerie Smith of Duke University School of Medicine, Theodore Berkowitz of Durham VA Health Care System, David Edelman of Duke University School of Medicine, Courtney H. Van Houtven of Duke University School of Medicine, Sandra L. Woolson of Durham VA Health Care System, Christine M. Everett of Duke University School of Medicine, Brandolyn S. White of Durham VA Health Care System and George L. Jackson of Duke University School of Medicine.

Abstract

Because of workforce needs and demographic and chronic disease trends, nurse practitioners (NPs) and physician assistants (PAs) are taking a larger role in the primary care of medically complex patients with chronic conditions. Research shows good quality outcomes, but concerns persist that NPs’ and PAs’ care of vulnerable populations could increase care costs compared to the traditional physician-dominated system. We used 2012–13 Veterans Affairs data on a cohort of medically complex patients with diabetes to compare health services use and costs depending on whether the primary care provider was a physician, NP, or PA. Case-mix-adjusted total care costs were 6–7 percent lower for NP and PA patients than for physician patients, driven by more use of emergency and inpatient services by the latter. We found that use of NPs and PAs as primary care providers for complex patients with diabetes was associated with less use of acute care services and lower total costs.

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