The NHAMCS uses a 4-stage probability sampling procedure to collect nationally representative data. We analyzed data from the outpatient department subset of the NHAMCS, which is administered annually by the National Center for Health Statistics at the Centers for Disease Control and Prevention and is designed to collect data on the use and provision of ambulatory care services in hospital emergency and outpatient departments (7). The objective of our study was to evaluate the rate of health education provision to patients by physicians, physician assistants, and nurse practitioners/certified midwives. The question of provider differences is especially important as we consider how health care teams should be configured to meet the health care needs of Americans after implementation of the Affordable Care Act in 2014. One study used the National Hospital Ambulatory Medical Care Survey (NHAMCS) to compare nurse practitioners with all other types of health professionals and found that nurse practitioners were more likely than physicians to provide preventive health counseling to patients (6). Data are scarce on differences between provider types because most large federal clinical databases do not collect data by provider type or on health education. Barriers to the provision of quality health education may include failure of insurance companies to provide reimbursement for education services, lack of time to spend in counseling, and lack of confidence or skill in counseling among health care providers (3–5).Īdditionally, there has been little study on whether some types of health care providers are more likely than others to provide health education to patients. Literature across a variety of specialties indicates that health professionals often fail to provide health education, resulting in ineffective therapies, return visits, and iatrogenic illnesses (1,2). Health education is, therefore, a vital preventive element in the patient visit. Patients cannot perform daily self-management tasks if they have poor understanding of the disease process, medications used, or the practical tasks they need to accomplish to care for themselves. More research is needed to understand the causes of these differences and potential opportunities to increase the delivery of condition-specific education to patients.ĭisease self-management is an essential component of care for patients with most chronic conditions. Possible explanations include training differences, differing roles within a clinic by provider type, or increased clinical demands on physicians. Physician assistants and nurse practitioners provided health education to patients with chronic illness more regularly than did physicians, although none of the 3 types of clinicians routinely provided health education. For all conditions assessed, rates of health education were higher among physician assistants and nurse practitioners than among physicians. The percentage of patients who received education on their chronic condition ranged from 13.0% (patients with COPD or asthma who were provided education on smoking cessation by nurse practitioners) to 42.2% (patients with diabetes or obesity who were provided education on exercise by physician assistants). Health education was not routinely provided to patients who had a chronic condition. We abstracted data on 136,432 adult patient visits for the following chronic conditions: asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, and obesity. We analyzed 5 years of data (2005–2009) from the outpatient department subset of the National Hospital Ambulatory Medical Care Survey. The objective of our study was to evaluate the rate of health education provision by physicians, physician assistants, and nurse practitioners/certified midwives. Although some studies describe the provision of health education by physicians, few studies have examined how physicians, physician assistants, and nurse practitioners differ in the provision of health education. Health education provided to patients can reduce mortality and morbidity of chronic disease. Differences in the Delivery of Health Education to Patients With Chronic Disease by Provider Type, 2005–2009. Suggested citation for this article: Ritsema TS, Bingenheimer JB, Scholting P, Cawley JF. Bingenheimer, PhD, MPH Patty Scholting, MPAS, PA-C James F.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |