better outcomes from primary care by nurse practitioners | Real Data
Having NP's with more influence / prescribing rights, the data for health care is positive for NP's.
US Medicare patients with diabetes who receive their care from nurse practitioners are slightly less likely to be hospitalized for a potentially preventable condition compared with those cared for by physicians, according to a study published recently in Medical Care.
"These results may represent a valid finding of better outcomes from primary care delivered by nurse practitioners," write Yong-Fang Kuo, PhD, and colleagues at the University of Texas Medical Branch in Galveston. "Alternatively, they may have resulted from confounding by selection biases not completely controlled for in the analyses."
The researchers compared potentially preventable hospitalizations from 2007 to 2010 among 345,819 Medicare patients with any diagnosis of diabetes. Of these, 93,443 patients had received all their primary care from nurse practitioners (a total of 136,348 person-years), and 252,376 patients had received all their care from a generalist physician (553,890 person-years).
Nurse practitioners' patients had a 10% lower risk of hospitalization for a potentially preventable condition (odds ratio [OR], 0.90) and a 6% lower risk of hospitalization for poor diabetes control, such as hypoglycemia or hyperglycemia (OR, 0.94), compared with patients of physicians. Similarly, the odds for hospitalization for other conditions was slightly lower among nurse practitioners' patients than among physicians' patients (OR, 0.96).
All-cause mortality between the groups was not statistically different over 4 years, however. In the nurse-practitioner group, 17.15% of patients died, compared with 16.97% of physicians' patients (adjusted hazard ratio, 1.00; 95% CI, 0.97–1.03).
"We find it surprising that the findings of lower rate of potentially avoidable hospitalization among nurse practitioners patients still hold true, despite use of multiple advanced analyses to adjust for complexity and severity of illnesses between diabetes patients cared for by nurse practitioners vs MDs," coauthor Mukaila A Raji, MD, told Medscape Medical News.
