Health Care Resource Utilization for Outpatient Cardiovascular Disease and Diabetes Care Delivery among Advanced Practice Providers and Physician Providers in Primary Care

Salim S. Virani, Julia M. Akeroyd, David J. Ramsey, Anita Deswal, Khurram Nasir, Suja S. Rajan, Christie M. Ballantyne, Laura A. Petersen

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Although effectiveness of diabetes or cardiovascular disease (CVD) care delivery between physicians and advanced practice providers (APPs) has been shown to be comparable, health care resource utilization between these 2 provider types in primary care is unknown. This study compared health care resource utilization between patients with diabetes or CVD receiving care from APPs or physicians. Diabetes (n = 1,022,588) or CVD (n = 1,187,035) patients with a primary care visit between October 2013 and September 2014 in 130 Veterans Affairs facilities were identified. Using hierarchical regression adjusting for covariates including patient illness burden, the authors compared number of primary or specialty care visits and number of lipid panels and hemoglobinA1c (HbA1c) tests among diabetes patients, and number of primary or specialty care visits and number of lipid panels and cardiac stress tests among CVD patients receiving care from physicians and APPs. Physicians had significantly larger patient panels compared with APPs. In adjusted analyses, diabetes patients receiving care from APPs received fewer primary and specialty care visits and a greater number of lipid panels and HbA1c tests compared with patients receiving care from physicians. CVD patients receiving care from APPs received more frequent lipid testing and fewer primary and specialty care visits compared with those receiving care from physicians, with no differences in the number of stress tests. Most of these differences, although statistically significant, were numerically small. Health care resource utilization among diabetes or CVD patients receiving care from APPs or physicians appears comparable, although physicians work with larger patient panels.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
JournalPopulation Health Management
Volume21
Issue number3
DOIs
StatePublished - Jun 2018

Keywords

  • advanced practice providers
  • cardiovascular disease
  • diabetes
  • health care resource utilization
  • physicians

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

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