Online Program

Diagnosing Depression: The Role of Physician Assistants and Nurse Practitioners

Wednesday, November 4, 2015

Abiola Keller, PA-C, MPH, PhD, Department of Physician Assistant Studies, Marquette University, Milwaukee, WI
Lisa Rein, MS, Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI
Aniko Szabo, PhD, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI
Elizabeth A. Jacobs, MD, MAPP, Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
Background/purpose: Expansion of services delivered by physician assistants (PA) and nurse practitioners (NP) has been suggested as a solution for meeting the anticipated increased demand for health services. Yet, little is known about the role these providers play in the delivery of depression services within primary care. This study examined the relationship between provider type and the diagnosis of depression in primary care visits in the US.

Methods/approach: Primary care visits from the 2004-2010 National Ambulatory Medical Care Survey, a nationally representative sample of outpatient office visits, were analyzed. Survey-adjusted multivariate logistic regression was used to examine the independent contribution of the type of provider seen (Physician vs PA/NP only) on the likelihood of having a new depression diagnosis, defined as a visit for a new problem with depression identified as the primary diagnosis.

Findings: 96.4% of the 8,253,097 (weighted, unweighted n= 232) primary care visits with a new depression diagnosis were attended by physicians compared to a 98.4% for all visits. Logistic regression results showed an increased likelihood of having a visit with a new depression diagnosis when the visit was attended by a PA or NP only (OR=2.1; 95% CI = 0.87-4.9); however, this finding was not statistically significant (p = 0.10).

Implications: These findings suggest that when given the opportunity, PAs and NPs are playing an active role in the recognition of depression within primary care visits. Increased utilization of these providers may improve access to depression care.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Identify the proportion of visits with a new depression diagnosis attended by physicians. Compare the likelihood of having a visit with a new depression diagnosis being attended by a physician assistant or nurse practitioner to a physician.

Keyword(s): Depression, Workforce

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on this funded project and have conducted and published several studies related to access to and quality of depression treatment.
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.