Evidence map›Paper›PMID 38989998›Full record

ArticleNursing research

Acute Care Use Among Patients With Multiple Chronic Conditions Receiving Care From Nurse Practitioner Practices in Health Professional Shortage Areas.

Amy McMenamin, Eleanor Turi, Justinna Dixon, Jianfang Liu, Grant Martsolf, Lusine Poghosyan

Abstract read
In one paragraph

Article in Nursing research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

6 authors.

Funding

Systems Science and Comparative and Cost-Effectiveness Research Training for Nurse Scientists (S2CER2)T32NR014205 · NINR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Lusine Poghosyan, Jingjing Shang · 2013 to 2026
$4.2M
Racial and Ethnic Disparities in Chronic Disease Outcomes and Nurse Practitioner PracticeR01MD011514 · NIMHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI POGHOSYAN, LUSINE · 2017 to 2020
$3.0M
The academic-community experience (ACE): A postdoctoral training fellowship in implementation science to promote mental healthT32MH109433 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI David S Mandell · 2017 to 2026
$2.4M
The Impact of Nurse Practitioner Work Environment and Community Characteristics on Acute Care Utilization by Older Adults with Multiple Chronic ConditionsR36HS029435 · AHRQ · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MCMENAMIN, AMY L · 2023 to 2023
$42k
AHRQ HHS R36 HS029435NIMHD NIH HHS R01 MD011514NIMH NIH HHS T32 MH109433NINR NIH HHS T32 NR014205
6 · The paper itself

Abstract

backgroundPatients with multiple chronic conditions often have many care plans, polypharmacy, and unrelieved symptoms that contribute to high emergency department and hospital use. High-quality primary care delivered in practices that employ nurse practitioners can help prevent the need for such acute care services. However, such practices located in primary care health professional shortage areas face challenges caring for these patients because of higher workloads and fewer resources.

objectiveWe examined differences in hospitalization and emergency department use among patients with multiple chronic conditions who receive care from practices that employ nurse practitioners in health professional shortage areas compared to practices that employ nurse practitioners in non-health professional shortage areas.

methodsWe performed an analysis of Medicare claims, merged with Health Resources and Services Administration data on health professional shortage area status in five states. Our sample included 394,424 community-dwelling Medicare beneficiaries aged ≥65 years, with at least two of 15 common chronic conditions who received care in 779 practices that employ nurse practitioners. We used logistic regression to assess the relationship between health professional shortage area status and emergency department visits or hospitalizations.

resultsWe found a higher likelihood of emergency department visits among patients in health professional shortage areas compared to those in non-health professional shortage areas and no difference in the likelihood of hospitalization. DISCUSSION: Emergency department use differences exist among older adults with multiple chronic conditions receiving care in practices that employ nurse practitioners in health professional shortage areas, compared to those in non-health professional shortage areas. To address this disparity, the health professional shortage area program should invest in recruiting and retaining nurse practitioners to health professional shortage areas to ease workforce shortages.

Indexed as

MedicareNurse PractitionersAgedAged, 80 and overEmergency Service, HospitalFemaleHospitalizationHumansMaleMultiple Chronic ConditionsPrimary Health CareUnited States

Identifiers

PMID38989998
PMCPMC11344658

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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.