ArticleJournal of the American Medical Directors Association2019
Association Between Clinician Specialization in Nursing Home Care and Nursing Home Clinical Quality Scores.
Article in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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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.
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Who cites it
13 citing papers in PubMed, 27 citations in OpenAlex.
- Clinician Specialization in Skilled Nursing Facility Practice and Post-Acute Outcomes of Patients With Dementia.Health services research · 2026Article
- Clinicians Who Practice Primarily in Nursing Homes and the Quality of Care for Residents With Alzheimer Disease and Related Dementias.JAMA health forum · 2025Article
- Antibiotic Prescribing Patterns for Urinary Tract Infections and Pneumonia by Prescriber Type and Specialty in Nursing Home Care, 2016-2018.Journal of the American Medical Directors Association · 2024Article
- Clinicians Who Practice Primarily in Nursing Homes and the Quality of End-of-Life Care Among Residents.JAMA network open · 2024Article
- Clinicians who primarily practice in nursing homes and outcomes among residents with urinary tract infection or pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Potentially Harmful Medication Prescribing by the Degree of Physician Specialization in Nursing Home Practice: An Observational Study.Journal of the American Medical Directors Association · 2023Observational
- Use of Clinicians Who Focus on Nursing Home Care Among US Nursing Homes and Unplanned Rehospitalization.JAMA network open · 2023Article
- Factors Associated with Potentially Harmful Medication Prescribing in Nursing Homes: A Scoping Review.Journal of the American Medical Directors Association · 2022Article
- Defining the Role and Value of Physicians Who Primarily Practice in Nursing Homes: Perspectives of Nursing Home Physicians.Journal of the American Medical Directors Association · 2022Article
- Medical Care Delivery in U.S. Nursing Homes: Current and Future Practice.The Gerontologist · 2021Review
- How Do German General Practitioners Assess Medical Specialist Care Needs of Nursing Home Residents? Results of a Postal Survey in North-Western Germany.International journal of environmental research and public health · 2020Article
- Patient and Caregiver Perceptions of Nursing Home Physicians: Insight from Yelp Reviews, 2009-2018.Journal of the American Geriatrics Society · 2020Article
- Identifying Structure, Process and Outcome Factors of the Clinical Specialist Nurse: A Scoping Review Study.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
importanceWhile the number of prescribing clinicians (physicians and nurse practitioners) who provide any nursing home care remained stable over the past decade, the number of clinicians who focus their practice exclusively on nursing home care has increased by over 30%.
objectivesTo measure the association between regional trends in clinician specialization in nursing home care and nursing home quality.
designRetrospective cross-sectional study. SETTING AND
participantsPatients treated in 15,636 nursing homes in 305 US hospital referral regions between 2013 and 2016. MEASURES: Clinician specialization in nursing home care for 2012-2015 was measured using Medicare fee-for-service billings. Nursing home specialists were defined as generalist physicians (internal medicine, family medicine, geriatrics, and general practice) or advanced practitioners (nurse practitioners and physician assistants) with at least 90% of their billings for care in nursing homes. The number of clinicians was aggregated at the hospital referral region level and divided by the number of occupied Medicare-certified nursing home beds. Nursing Home Compare quality measure scores for 2013-2016 were aggregated at the HHR level, weighted by occupied beds in each nursing home in the hospital referral region. We measured the association between the number of nursing home specialists per 1000 beds and the clinical quality measure scores in the subsequent year using linear regression.
resultsAn increase in nursing home specialists per 1000 occupied beds in a region was associated with lower use of long-stay antipsychotic medications and indwelling bladder catheters, higher prevalence of depressive symptoms, and was not associated with urinary tract infections, use of restraints, or short-stay antipsychotic use. CONCLUSIONS AND IMPLICATIONS: Higher prevalence of nursing home specialists was associated with regional improvements in 2 of 6 quality measures. Future studies should evaluate whether concentrating patient care among clinicians who specialize in nursing home practice improves outcomes for individual patients. The current findings suggest that prescribing clinicians play an important role in nursing home care quality.
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Registered trials
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.