March 2, 2017

NPs and PAs performed as well as doctors on quality in community health centers, study finds

Daily Briefing

    Nurse practitioners (NPs) and physician assistants (PAs) provide the same quality of care in community health centers as doctors, according to a new study published in Medical Care.

    The study, which was conducted by researchers from George Washington University, relied on data the National Ambulatory Medical Care Survey collected between 2006 and 2010. Researchers assessed nine care outcomes by provider type: 

    • Two measures of referral pattern, including scheduling a return visit at a specific time and physician referrals;
    • Three quality indicators, including smoking cessation counseling, depression treatment, and the ordering and prescribing of statins for hyperlipidemia; and 
    • Four measures of service utilization, including physical exams, total number of health education and counseling services, imaging services, and total number of medications.

    According to the study, PAs and NPs delivered care comparable to that of doctors in seven of the nine measures.

    Is this the primary care office of the future?

    And on two measures, the other clinicians actually outperformed doctors. The researchers found that patients seeing NPs were more likely to receive health education and smoking cessation counseling than patients seeing primary care physicians, while PAs were more likely to deliver health education counseling than primary care physicians.

    Ellen Kurtzman—lead author of the study and associate professor in the school of nursing at George Washington University—said the study "should be reassuring to patients who rely on community health centers for their care." She added, "We found that care is likely to be comparable regardless of whether patients are seen by a nurse practitioner, physician assistant or physician" (Wallace, UPI, 2/27; Zimmerman, Becker's Infection Control & Clinical Quality, 2/28; George Washington University press release, 2/27).

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    redesigning the primary care clinic

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