Abstract
To examine the process and outcomes of care of COPD patients by Advanced Practice Providers (APPs) and primary care physicians. We conducted a cross sectional retrospective cohort study of Medicare beneficiaries with COPD who had at least one hospitalization in 2010. We examined the process measures of receipt of spirometry evaluation, influenza and pneumococcal vaccine, use of COPD medications, and referral to a pulmonary specialist visit. Outcome measures were emergency department (ER) visit, number of hospitalizations and 30-day readmission in 2010. A total of 7,257 Medicare beneficiaries with COPD were included. Of these, 1,999 and 5,258 received primary care from APPs and primary care physicians, respectively. Patients in the APP group were more likely to be white, younger, male, residing in non-metropolitan areas and have fewer comorbidities. In terms of process of care measures, APPs were more likely to prescribe short acting bronchodilators (adjusted odds ratio [aOR] = 1.18, 95%Confidence Interval [CI] 1.05-1.32), oxygen therapy (aOR = 1.25, 95% CI 1.12-1.40) and consult a pulmonary specialist (aOR = 1.39, 95% CI 1.23-1.56), but less likely to give influenza and pneumococcal vaccinations. Patients receiving care from AP...Continue Reading
References
Jan 13, 2000·JAMA : the Journal of the American Medical Association·M O MundingerM L Shelanski
Apr 14, 2000·BMJ : British Medical Journal·P VenningB Leese
Apr 6, 2002·BMJ : British Medical Journal·Sue HorrocksChris Salisbury
Aug 31, 2002·BMJ : British Medical Journal·David E MittmanWilliam H Fenn
Sep 13, 2002·The Diabetes Educator·Elizabeth R LenzJanice L Smolowitz
Jul 10, 2003·Journal of Interprofessional Care·David LitakerJoseph Frolkis
Feb 5, 2009·Journal of Advanced Nursing·Angelique T M Dierick-van DaeleHubertus J M Vrijhoef
Oct 13, 2010·Archives of Internal Medicine·Gulshan SharmaJames S Goodwin
Dec 17, 2010·The New England Journal of Medicine·Julie A FairmanDonna E Shalala
Aug 20, 2011·Health & Social Care in the Community·Roderick S Hooker, Christine M Everett
Nov 15, 2012·Annals of Family Medicine·Stephen M PettersonAndrew W Bazemore
Feb 22, 2013·Health Affairs·Elbert S Huang, Kenneth Finegold
May 17, 2013·The New England Journal of Medicine·John K Iglehart
Jul 10, 2013·Health Affairs·Yong-Fang KuoJames S Goodwin
Jul 23, 2013·Nursing Outlook·Catherine M DesRochesPeter Buerhaus
Nov 6, 2013·Health Affairs·Christine EverettMaureen A Smith
Dec 7, 2013·Medical Care·Peggy Guey-Chi ChenDavid I Auerbach
Dec 7, 2013·Medical Care·Robert L PhillipsLars E Peterson
Jan 16, 2014·Annals of the American Thoracic Society·Valentin Prieto-CenturionJerry A Krishnan
Jun 3, 2014·BMC Health Services Research·Nahara Anani Martínez-GonzálezThomas Rosemann
Aug 29, 2014·Chest·Deena Kelly CostaJeremy M Kahn
Nov 25, 2014·JAMA Internal Medicine·Danny R HughesRichard Duszak
Jan 23, 2015·Chest·Rachel GavishNimrod Maimon
Citations
Jun 27, 2018·Haemophilia : the Official Journal of the World Federation of Hemophilia·A FederizoM Witkop
Dec 7, 2017·Current Opinion in Pulmonary Medicine·Valerie G PressSteven R White
May 23, 2020·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Álvaro FríasMeritxell Antón
Sep 8, 2020·International nursing review·O Prajankett, A Markaki
Dec 1, 2019·BMC Health Services Research·Kelly Cristina Gomes AlvesOtaliba Libânio de Morais Neto
Dec 5, 2020·Medical Care·Moaven RazaviPeter Buerhaus
Sep 7, 2021·Journal of Nursing Care Quality·Huey-Ming TzengYong-Fang Kuo