222730 Nebraska's non-physician providers: Gap-fillers in primary care?

Wednesday, November 10, 2010

Bettye Apenteng , College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE
Keith Mueller, PhD , College of Public Health, Department of Health Management and Policy, University of Iowa, Iowa City, IA
Preethy Nayar, PhD , College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE
Background: Non-physician providers (NPs & PAs) have been traditionally used in primary care as gap fillers to address shortages of primary care physicians. Studies have indicated that non-physician providers are more likely than physicians to serve rural and underserved populations (Strickland et al, 1998; Everett et al, 2009). In Nebraska, empirical assessment of their role in filling gaps in primary care provision is limited. Much of the literature on shortage areas focus on simple professional to population ratios. This study however, places emphasis on assessing whether non-physician providers are meeting a need for primary care in Nebraska's counties. Methods: Using regression modeling we examined the relationships between the ratio of non-physicians to population in Nebraska's counties and measures of need (Wang & Luo, 2005) for primary care services. Findings: We found a negative association between the non-physician to population ratio and the percentage of the population with a high need for primary care services (i.e. total population under 5 years, women between age 15 and 44 and seniors over 65 years old) (p <0.05). However, counties with higher rates of poverty (p<0.05) as well as those with better self-reported population health status (p<0.001) were found to have a higher proportion of non-physician providers. Conclusion: Our findings suggest that Nebraska's non-physician providers may not be practicing in areas with a higher need for primary care services. Recruitment and retention policies for non-physician providers should focus more on meeting the needs of populations with a higher need for primary care.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
1. Define high need population for primary care services. 2.Identify populations and areas with high need for primary care in their own communities 3.Design recruitment and retention strategies for primary healthcare providers that target these high need populations and areas.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student in Health Services Research Administration at the University of Nebraska Medical Center and I embarked on this as a research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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