Nursing home (NH) residents are at high risk of avoidable emergency department (ED) visits and hospitalizations. One reason is lack of availability of primary care providers.
For the 20% of primary care physicians who practice in NHs, NH care accounts for less than 10% of their overall work time.
Studies in Europe and the United States have found that NHs whose physicians or advance practice nurses devote full time to NH residents have lower rates of hospitalizations and ED visits. A new U.S. study suggests the same.
The researchers assessed whether NH residents whose primary care providers (PCPs) – whether physician, physician assistant, or advanced practice nurse –spent most of their clinical effort at NHs would have fewer avoidable hospitalizations and lower Medicare costs.
They found that residents whose PCPs devoted less than 5% of their clinical effort to NH care were at 52% higher risk of potentially avoidable hospitalizations than those whose PCPs devoted 85% or more of their clinical effort to NHs. Those residents also had $2,179 higher annual Medicare spending, controlling for PCP discipline.
For more info, see Kuo et al. (2013). Association between proportion of provider clinical effort in nursing homes and potentially avoidable hospitalizations and medical costs of nursing home residents. Journal of the American Geriatric Society, 61, 1750-1757.