The roles of primary care PAs and NPs caring for older adults with diabetes

doi:10.1097/01.JAA.0000444736.16669.76

. 2014 Apr;27(4):45-9.

doi: 10.1097/01.JAA.0000444736.16669.76.

The roles of primary care PAs and NPs caring for older adults with diabetes

Christine M Everett¹, Carolyn T Thorpe, Mari Palta, Pascale Carayon, Valerie J Gilchrist, Maureen A Smith

Affiliations

Affiliation

¹ Christine M. Everett is an assistant professor in the PA program at Duke University School of Medicine in Durham, N.C. Carolyn T. Thorpe is an assistant professor in Health Services Research and Development at the Veterans Affairs Pittsburgh Healthcare System and in the Department of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy in Pittsburgh, Pa. Mari Palta is a professor in the Department of Population Health Sciences at the University of Wisconsin-Madison. Pascale Carayon is a professor in the Center for Quality and Productivity Improvement in the Department of Industrial and Systems Engineering at the University of Wisconsin-Madison. Valerie J. Gilchrist is a professor and department chair of the Department of Family Medicine at the University of Wisconsin-Madison. Maureen A. Smith is a professor in the departments of population health sciences, family medicine, and surgery at the University of Wisconsin-Madison. The authors disclose that funding for this project was provided by the Agency for Healthcare Research and Quality, grant numbers R21 HS017646 and R01 HS018368. Additional support was provided by the Health Innovation Program, which assisted with institutional review board application, Medicare data management, variable creation, and manuscript formatting; the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health; and the UW School of Medicine and Public Health from the Wisconsin Partnership Program. One author was supported by the AHRQ/National Research Service Award T-32 Institutional Training Program Grant Number: 5-T32-HS00083 and the American Academy of Physician Assistants' Breitman-Dorn Fellowship. No other funding source had a role in the design or conduct; data collection, management

PMID: 24662258
PMCID: PMC4221794
DOI: 10.1097/01.JAA.0000444736.16669.76

The roles of primary care PAs and NPs caring for older adults with diabetes

Christine M Everett et al. JAAPA. 2014 Apr.

. 2014 Apr;27(4):45-9.

doi: 10.1097/01.JAA.0000444736.16669.76.

Authors

Christine M Everett¹, Carolyn T Thorpe, Mari Palta, Pascale Carayon, Valerie J Gilchrist, Maureen A Smith

Affiliation

¹ Christine M. Everett is an assistant professor in the PA program at Duke University School of Medicine in Durham, N.C. Carolyn T. Thorpe is an assistant professor in Health Services Research and Development at the Veterans Affairs Pittsburgh Healthcare System and in the Department of Pharmacy and Therapeutics at the University of Pittsburgh School of Pharmacy in Pittsburgh, Pa. Mari Palta is a professor in the Department of Population Health Sciences at the University of Wisconsin-Madison. Pascale Carayon is a professor in the Center for Quality and Productivity Improvement in the Department of Industrial and Systems Engineering at the University of Wisconsin-Madison. Valerie J. Gilchrist is a professor and department chair of the Department of Family Medicine at the University of Wisconsin-Madison. Maureen A. Smith is a professor in the departments of population health sciences, family medicine, and surgery at the University of Wisconsin-Madison. The authors disclose that funding for this project was provided by the Agency for Healthcare Research and Quality, grant numbers R21 HS017646 and R01 HS018368. Additional support was provided by the Health Innovation Program, which assisted with institutional review board application, Medicare data management, variable creation, and manuscript formatting; the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 1UL1RR025011 from the Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health; and the UW School of Medicine and Public Health from the Wisconsin Partnership Program. One author was supported by the AHRQ/National Research Service Award T-32 Institutional Training Program Grant Number: 5-T32-HS00083 and the American Academy of Physician Assistants' Breitman-Dorn Fellowship. No other funding source had a role in the design or conduct; data collection, management

PMID: 24662258
PMCID: PMC4221794
DOI: 10.1097/01.JAA.0000444736.16669.76

Abstract

Electronic health record data linked with Medicare data from an academic physician group were used to propose a multidimensional characterization of PA and NP roles on panels of primary care patients with diabetes. Seven PA and NP roles were defined based on level of involvement, visits with complex patients, and delivery of chronic care. Findings suggest that PAs and NPs in primary care perform a variety of roles and frequently perform multiple roles within a clinic.

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Figures

**Figure 1**
PA/NP Roles on Panels with Medicare Patients with Diabetes (N=263). PA = Physician Assistant; NP = Nurse Practitioner.

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References

1. Barr M, Ginsburg J. The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care. American College of Physicians; Philadelphia: 2006.
1. Gorden MS, DuMoulin JP. Patient-Centered, Physician-Guided Care for the Chronically Ill: American College of Physicians Prescription for Change. American College of Physicians; Philadelphia: 2004.
1. Grumbach K, Bodenheimer T. A primary care home for Americans: putting the house in order. JAMA. 2002 Aug 21;288(7):889–893. - PubMed
1. Fields D, Leshen E, Patel K. Analysis & commentary: Driving quality gains and cost savings through adoption of medical homes. Health Aff. 2010 May 1;29(5):819–826. 2010. - PubMed
1. American Academy of Family Physicians. American Academy of Pediatrics. American College of Physicians. American Osteopathic Association . Joint Principles of the Patient-Centered Medical Home. American Academy of Family Physicians; Leawood, KS: Mar, 2007.

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[1] Barr M, Ginsburg J. The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care. American College of Physicians; Philadelphia: 2006.

[2] Barr M, Ginsburg J. The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care. American College of Physicians; Philadelphia: 2006.

[3] Gorden MS, DuMoulin JP. Patient-Centered, Physician-Guided Care for the Chronically Ill: American College of Physicians Prescription for Change. American College of Physicians; Philadelphia: 2004.

[4] Gorden MS, DuMoulin JP. Patient-Centered, Physician-Guided Care for the Chronically Ill: American College of Physicians Prescription for Change. American College of Physicians; Philadelphia: 2004.

[5] Grumbach K, Bodenheimer T. A primary care home for Americans: putting the house in order. JAMA. 2002 Aug 21;288(7):889–893. - PubMed

[6] Grumbach K, Bodenheimer T. A primary care home for Americans: putting the house in order. JAMA. 2002 Aug 21;288(7):889–893. - PubMed

[7] Fields D, Leshen E, Patel K. Analysis & commentary: Driving quality gains and cost savings through adoption of medical homes. Health Aff. 2010 May 1;29(5):819–826. 2010. - PubMed

[8] Fields D, Leshen E, Patel K. Analysis & commentary: Driving quality gains and cost savings through adoption of medical homes. Health Aff. 2010 May 1;29(5):819–826. 2010. - PubMed

[9] American Academy of Family Physicians. American Academy of Pediatrics. American College of Physicians. American Osteopathic Association . Joint Principles of the Patient-Centered Medical Home. American Academy of Family Physicians; Leawood, KS: Mar, 2007.

[10] American Academy of Family Physicians. American Academy of Pediatrics. American College of Physicians. American Osteopathic Association . Joint Principles of the Patient-Centered Medical Home. American Academy of Family Physicians; Leawood, KS: Mar, 2007.

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The roles of primary care PAs and NPs caring for older adults with diabetes

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