Diagnosing Depression: The Role of Physician Assistants and Nurse Practitioners
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
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
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.