Evidence map›Paper›PMID 26910566›Full record

ArticlePloS one2016

Process and Outcome Measures among COPD Patients with a Hospitalization Cared for by an Advance Practice Provider or Primary Care Physician.

Amitesh Agarwal, Wei Zhang, YongFang Kuo, Gulshan Sharma

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Integration of Advanced Practice Providers into Independent Surgical Groups.Journal of the American College of Surgeons · 2025
    Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Amitesh AgarwalDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America.
Wei ZhangDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America.
YongFang KuoOffice of Biostatistics, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America.
Gulshan SharmaDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, United States of America.
The University of Texas Medical Branch at Galveston · US

Funding

Patient Centered Outcomes Research in the ElderlyR24HS022134 · AHRQ · UNIVERSITY OF TEXAS MED BR GALVESTON · PI GOODWIN, MD, JAMES S. · 2013 to 2017
$4.8M
Assessing The Role of Nurse Practitioner in Primary Care of Older AdultsR01HS020642 · AHRQ · UNIVERSITY OF TEXAS MED BR GALVESTON · PI KUO, YONG-FANG · 2012 to 2019
$1.4M
AHRQ HHS R01 HS020642AHRQ HHS R01-HS020642AHRQ HHS R24 HS022134AHRQ HHS R24-HS022134
6 · The paper itself

Abstract

objectivesTo examine the process and outcomes of care of COPD patients by Advanced Practice Providers (APPs) and primary care physicians.

methodsWe conducted a cross sectional retrospective cohort study of Medicare beneficiaries with COPD who had at least one hospitalization in 2010. We examined the process measures of receipt of spirometry evaluation, influenza and pneumococcal vaccine, use of COPD medications, and referral to a pulmonary specialist visit. Outcome measures were emergency department (ER) visit, number of hospitalizations and 30-day readmission in 2010.

resultsA total of 7,257 Medicare beneficiaries with COPD were included. Of these, 1,999 and 5,258 received primary care from APPs and primary care physicians, respectively. Patients in the APP group were more likely to be white, younger, male, residing in non-metropolitan areas and have fewer comorbidities. In terms of process of care measures, APPs were more likely to prescribe short acting bronchodilators (adjusted odds ratio [aOR] = 1.18, 95%Confidence Interval [CI] 1.05-1.32), oxygen therapy (aOR = 1.25, 95% CI 1.12-1.40) and consult a pulmonary specialist (aOR = 1.39, 95% CI 1.23-1.56), but less likely to give influenza and pneumococcal vaccinations. Patients receiving care from APPs had lower rates of ER visits for COPD (aOR = 0.84, 95%CI 0.71-0.98) and had a higher follow-up rate with pulmonary specialist within 30 days of hospitalization for COPD (aOR = 1.25, 95%CI 1.07-1.48) than those cared for by physicians.

conclusionsCompared to patients cared for by physicians, patients cared for by APPs were more likely to receive short acting bronchodilator, oxygen therapy and been referred to pulmonologist, however they had lower rates of vaccination probably due to lower age group. Patients cared for by APPs were less like to visit an ER for COPD compared to patients care for by physicians, conversely there was no differences in hospitalization or readmission for COPD between MDs and APPs.

Indexed as

HospitalizationNurse PractitionersOutcome Assessment, Health CarePhysician AssistantsPhysicians, Primary CareAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMedicarePulmonary Disease, Chronic ObstructiveRetrospective StudiesUnited States

Identifiers

PMID26910566
PMCPMC4765888
OpenAlexW2280090757

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.