Comparing Use of Low-Value Health Care Services Among U.S. midlevels & physicians

Specialties NP

Published

  • by PG2018
    Specializes in Outpatient Psychiatry.

Since no one ever posts any of these studies when I ask them to, I happened to find one sitting in my inbox this morning thanks to NEJM Journal Watch.

Comparing Use of Low-Value Health Care Services Among U.S. Advanced Practice Clinicians and PhysiciansProviding Value: Advanced Practice Clinicians Versus Physicians

Advanced Practice Clinicians and Physicians Provide Similar Levels of Care for Common Conditions — Physician’s First Watch=

[h=1]Advanced Practice Clinicians and Physicians Provide Similar Levels of Care for Common Conditions[/h]

By Kelly Young

Edited by David G. Fairchild, MD, MPH

Nurse practitioners and physician assistants are no more likely than physicians to provide low-value care for common health concerns, suggests an observational study in the Annals of Internal Medicine. An editorialist calls the results "reassuring."

Using data from two national surveys, researchers compared low-value care for three common conditions between physicians and advanced practice clinicians (nurse practitioners and physician assistants) in office- and hospital-based settings. The low-value care outcomes included the following:

  • For back pain: radiography or advanced imaging

  • For upper respiratory infection: antibiotic therapy or radiography

  • For headache: advanced imaging

  • Referral to another physician for any of these conditions

Based on 29,000 primary care visits, there were no significant differences between physicians and advanced practice clinicians for any of the outcomes after multivariable adjustment. However, in a subanalysis among primary care providers in hospital settings, advanced practice clinicians referred more patients than did physicians (12% vs. 8%).

[h=2]Link(s):[/h]Annals of Internal Medicine article (Free abstract)

Annals of Internal Medicine editorial (Subscription required)

Background: In Practice blog by nurse practitioners and physician assistants (Free)

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