Processes and Cost of Care for Older Adults With Diabetes Similar for NPs and PCPs
Guideline-Concordant Diabetes Care Similar With NPs, PCPs
(HealthDay News) -- The rates of processes of diabetes mellitus guideline-concordant care are similar, or slightly lower, for nurse practitioners (NPs) versus primary care physicians (PCPs), according to a study published in the October issue of the Journal of the American Geriatrics Society.
In a retrospective cohort study, Yong-Fang Kuo, Ph.D., from the University of Texas Medical Branch in Galveston, and colleagues compared processes and cost of care for older adults with diabetes cared for by NPs versus PCPs. Data were included from a national sample of 64,354 Medicare beneficiaries.
The researchers found that the rates of low-density lipoprotein cholesterol testing (odds ratio [OR], 1.01; 95 percent confidence interval [CI], 0.94 to 1.09) and nephropathy monitoring (OR, 1.05; 95 percent CI, 0.98 to 1.03) were similar for NPs and PCPs. Patients cared for by NPs had lower rates of eye examinations (OR, 0.89; 95 percent CI, 0.84 to 0.93) and glycated hemoglobin testing (OR, 0.88; 95 percent CI, 0.79 to 0.98). NPs were significantly more likely to have consulted cardiologists, endocrinologists, and nephrologists. They were also more likely to have prescribed potentially inappropriate medications (OR, 1.07; 95 percent CI, 1.01 to 1.12). Adjusted Medicare spending did not differ significantly between the groups (P = 0.56).
"NPs were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline-concordant care," the authors write.