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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 84 Research Studies Displayed
Rosen A, Cahill JM, Dugdale LS
Moral injury in health care: identification and repair in the COVID-19 Era.
The authors argue that a continuum exists between moral distress, moral injury, and burnout. They suggest that clear communication from leadership is essential for rectifying the morally injurious sense among health-care workers that executives prioritize revenue over patient and clinician health. They concluded that, in order to avoid widespread clinician burnout, moral injury must be identified and addressed before the wounds of health care result in permanent and irreversible loss.
Citation: Rosen A, Cahill JM, Dugdale LS . Moral injury in health care: identification and repair in the COVID-19 Era. J Gen Intern Med 2022 Nov;37(14):3739-43. doi: 10.1007/s11606-022-07761-5..
Keywords: COVID-19, Workforce, Provider: Health Personnel, Burnout, Stress
Fraze TK, Beidler LB, Savitz LA
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
The purpose of this study was to understand the motivations and concerns of health care organizations when implementing activities targeted at improving patients’ social conditions, such as housing, food, and economic insecurity. The researchers conducted semi-structured interviews with the administrators of 29 health care organizations to explore their issues around their agency’s provision of social care. Participants described an interconnected set of motivations for delivering social care: 1) doing the right thing for their patients, 2) improving health outcomes, and 3) business/ financial aspects. Administrators voiced uncertainty around a) responsible for social care, b) whether health care has the capacity and abilities to provide social care, and c) whether social care activities can be sustained. The researchers concluded that administrators of health care agencies and organizations could benefit from policy-maker guidance and support on how to effectively prioritize social care activities, partner with other sectors to provide social care, and develop the workforce that would be required to do so.
Citation: Fraze TK, Beidler LB, Savitz LA . "It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care. Med Care Res Rev 2022 Oct;79(5):701-16. doi: 10.1177/10775587211057673..
Keywords: Social Determinants of Health, Workforce
Fraiman YS, Montoya-Williams D, Ellis J
Plugging the leaky pipeline: the role of peer mentorship for increasing diversity.
This paper discusses the role of peer mentorship for increasing diversity in medicine. The authors discuss the role that mentorship of early career underrepresented in medicine (URiM), specifically by senior faculty with shared backgrounds, can have on improving health care workforce diversity. This mentorship can help to dismantle persistent and systemic institutional barriers.
Citation: Fraiman YS, Montoya-Williams D, Ellis J . Plugging the leaky pipeline: the role of peer mentorship for increasing diversity. Pediatrics 2022 Oct 1;150(4):e2021055925. doi: 10.1542/peds.2021-055925..
Keywords: Workforce, Training
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD . Training the next generation of learning health system scientists. Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Herb J, Holmes M, Stitzenberg K
Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017.
The purpose of this study was to assess trends over time in rural and urban disparities in the supply of surgeons treating patients with cancer. The researchers utilized the Area Health Resource File to conduct a retrospective observational study of medical workforce changes from 2004-2017. The study found that the density of surgical specialists in rural areas declined from 16 to 14 per 100,000 population and in urban areas from 33 to 31 per 100,000 population for a rural-urban disparity increase of 8%. The percentage increase in the supply disparity between the rural and urban workforce was largest for colorectal surgeons (66%) and general surgeons (72%). The study concluded that temporal changes in the rural-urban physician workforce depend on community factors, region, and area of specialization.
Citation: Herb J, Holmes M, Stitzenberg K . Trends in rural-urban disparities among surgical specialties treating cancer, 2004-2017. J Rural Health 2022 Sep;38(4):838-44. doi: 10.1111/jrh.12658..
Keywords: Rural Health, Disabilities, Surgery, Cancer, Workforce
Jin DP, Samuel S, Bowden K
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
The purpose of this study was to examine the use of training in ICU-specific electronic health record (EHR) workflows prior to redeployment of certified registered nurse anesthetists (CRNAs) as ICU clinicians during the COVID-19 surge. The researchers utilized clinical informatics (CI) fellows to lead a multidisciplinary team to deploy a customized HER curriculum consisting of in-person classes and online video modules. Eighteen CRNAs participated, with 15 completing surveys immediately after the in-person training session, and 12 participants completing a post-deployment survey. The study found that all respondents of the post-training survey thought the training was useful and improved their EHR skills. Of the 12 participants who completed the post-deployment survey, all said that the training both increased their comfort in the ICU and that the concepts learned would be useful in their anesthesia role, and 91% indicated the training prepared them to work in the ICU with minimal guidance. The researchers concluded that CI fellows are uniquely prepared to deliver EHR training for clinician deployment in operational crisis response.
Citation: Jin DP, Samuel S, Bowden K . Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge. Appl Clin Inform 2022 Aug 29;13(5):949-55. doi: 10.1055/a-1933-1798..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Training, Workforce
Merkow RP, Chung JW, Slota JM
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
This study’s objective was to understand how the Nurse Staffing Index (NSI) used in the US News and World Report “Best Hospitals” rankings correlates to actual nurse staffing levels. Nurse staffing data was obtained from publicly available data in the states of Illinois, California, and New Jersey. No other states had publicly accessible data. Hospital characteristics were obtained from the 2016 American Hospital Association (AHA) survey. The NSI was calculated using AHA data and is defined as the number of FTE RNs per adjusted patient day. Hospital characteristics were assessed using Hospital Compare data. Higher actual hospital-reported nurse staffing in Illinois and New Jersey was paradoxically associated with lower nurse staffing when measured by the NSI. California hospital-reported staffing intensity was weakly correctly with the NSI and RN nursing hours per patient day was not correlated with any of the 9 structural measures of hospital quality, while NSI was positively correlated with 3 of the 9 measures, particularly hospital volume status. None of the 11 outcome measures the authors assessed were associated with RN nursing hours per patient day or the NSI in either Illinois or California. All 12 patient experience measures were significantly and positively correlated with RN nursing hours in Illinois. However, none of the patient experience measures were significantly associated with the NSI in Illinois. The authors concluded that the NSI may not measure actual nurse staffing as intended.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Chung JW, Slota JM . Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing. J Nurs Care Qual 2022 Jul-Sep;37(3):195-98. doi: 10.1097/ncq.0000000000000619..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Provider: Nurse, Workforce
Cimiotti JP, Becker ER, Li Y
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
The purpose of this cross-sectional study was to determine if registered nurse workload was related with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. The researchers evaluated the records of Medicare beneficiaries ages 65 to 99 years with a primary diagnosis of sepsis that was present on admission to 1 of 1958 nonfederal, general acute care hospitals that had data on CMS SEP-1 scores and registered nurse workload. Researchers utilized 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims. The patient outcome of interest was mortality within 60 days of admission. The study found that 702,140 Medicare beneficiaries with a mean age of 78.2 years, 51% of whom were women, had a diagnosis of sepsis. In a multivariable regression model, each additional registered nurse hour per patient day (HPPD) was associated with a 3% decrease in the odds of 60-day mortality. The researchers concluded that hospitals which provide more registered nurse hours of care could possibly decrease the likelihood of mortality in Medicare beneficiaries with sepsis.
Citation: Cimiotti JP, Becker ER, Li Y . Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis. JAMA Health Forum 2022 May;3(5):e221173. doi: 10.1001/jamahealthforum.2022.1173..
Keywords: Sepsis, Mortality, Provider: Nurse, Nursing, Workforce
McBain RK, Cantor JH, Kofner A
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
This study examined the role that state Medicaid expansion has played in utilization of child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians for children with autism spectrum disorder (ASD). Health workforce data from HRSA was used to examine workforce growth from 2008-2017. State Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, and a 5% increase in child psychiatrists, but no association with growth in pediatrician utilization.
Citation: McBain RK, Cantor JH, Kofner A . Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder. J Autism Dev Disord 2022 Apr;52(4):1881-89. doi: 10.1007/s10803-021-05044-2..
Keywords: Children/Adolescents, Autism, Medicaid, Workforce, Behavioral Health
Post B, Nallamothu BK, Hollenbeck B
Hospital-cardiologist integration often occurs without a practice acquisition.
This study’s objective was to determine how much of the increase in hospital-cardiologist integration comes from acquisition of physician practices compared to individual employment decisions. Data from 2011 to 2018 was used from the American Medical Association Masterfile and Medicare. In 2011 18% of cardiologists were integrated, which rose to 25% in 2016. It was found that 48% of integrations occurred without acquisitions and that physicians who had completed residencies in the past 5 years had higher rates of integration that increased over time. Rates of early career physicians joining hospital systems also rose from 25% to 32% during that time period.
Citation: Post B, Nallamothu BK, Hollenbeck B . Hospital-cardiologist integration often occurs without a practice acquisition. Health Serv Res 2022 Apr;57(2):333-39. doi: 10.1111/1475-6773.13929..
Keywords: Hospitals, Provider: Physician, Healthcare Delivery, Workforce
Dierkes AM, Aiken LH, Sloane DM
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
The timely and effective administration of sepsis treatment may improve sepsis outcomes, and those improvements may provide evidence of the need for mandated reporting of adherence to sepsis care protocol. The purpose of the study was to better understand the association between patient-to-nurse staffing ratios, sepsis protocol compliance, and patient outcomes. The researchers conducted a cross-sectional study utilizing linked data from 537 hospitals from across California, Florida, Illinois, Pennsylvania, New Jersey, and New York (representing 252,699 Medicare inpatients with sepsis present on admission), nurse and hospital surveys, and Centers for Medicare and Medicaid Services Hospital Compare and the corresponding MedPAR patient claims. The study found that every additional patient per nurse was associated with greater odds of mortality, readmission, ICU admission, and greater risk of relative duration of stay. Every 10% increase in compliance of sepsis protocol was only associated with a shorter duration of stay. The study concluded that improvements in nurse staffing and the nurse-to-patient ratios had a greater impact on sepsis infection outcomes than compliance with protocols.
Citation: Dierkes AM, Aiken LH, Sloane DM . Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis. BMJ Open 2022 Mar 22;12(3):e056802. doi: 10.1136/bmjopen-2021-056802..
Keywords: Sepsis, Hospitals, Provider: Nurse, Workforce
Michelson KA, Cushing AM, Bucholz EM
Association of county-level availability of pediatricians with emergency department visits.
This study examined whether children in counties with more pediatricians had fewer emergency department (ED) visits. The authors conducted a cross-sectional study of all ED visits among children younger than 18 years from 6 states. Each additional pediatrician per 1000 children was associated with a 13.7% decrease in ED visits in the state-adjusted model. In the full model however, there was no association. Other factors such as presence of an urgent care facility, high socioeconomic status, urban status and higher proportions of White race and nonpublic insurance were also associated with decreased ED visit rates.
Citation: Michelson KA, Cushing AM, Bucholz EM . Association of county-level availability of pediatricians with emergency department visits. Pediatr Emerg Care 2022 Feb;38(2):e953-e57. doi: 10.1097/pec.0000000000002502..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Healthcare Utilization, Workforce, Provider: Physician, Rural Health
Zimmerman S, Carder P, Schwartz L
The imperative to reimagine assisted living.
Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. This article presents the background regarding those tensions, as well as potential solutions that have been borne out, paving the path to a better future of assisted living.
Citation: Zimmerman S, Carder P, Schwartz L . The imperative to reimagine assisted living. J Am Med Dir Assoc 2022 Feb;23(2):225-34. doi: 10.1016/j.jamda.2021.12.004..
Keywords: Elderly, Long-Term Care, Healthcare Delivery, Workforce, Quality of Care, Quality of Life, Healthcare Costs
Hemler JR, Edwards ST, Valenzuela S
The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative.
This study explored the relationship between disruptions in primary care practices and practice participation in facilitated quality improvement (QI). Using data from EvidenceNOW, findings showed that disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator.
Citation: Hemler JR, Edwards ST, Valenzuela S . The effects of major disruptions on practice participation in facilitation during a primary care quality improvement initiative. J Am Board Fam Med 2022 Jan-Feb;35(1):124-39. doi: 10.3122/jabfm.2022.01.210205..
Keywords: Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Workforce
Goodwin JS, Agrawal P, Li S
Growth of physicians and nurse practitioners practicing full time in nursing homes.
This retrospective cohort study examined the growth of physicians and nurse practitioners (NPs) and physician assistants (PAs) who work full time in nursing homes, and to assess resident and nursing home characteristics associated with receiving care from full-time providers. Researchers looked at a 20% national sample of Medicare data on long-term care residents in 2008 and 2018 and the physicians, NPs, and PAs who submitted charges for services rendered in nursing homes. Full-time nursing home providers increased from 26% in 2008 to 44.6% in 2017. The largest increase from 2008 to 2017 was in NPs with 1986 total in 2008 increasing 44.6% in 2017. Residents with an NP primary care provider were 23 times more likely to have a full-time provider. Residents who received care from both a physician and an NP or PA increased from 33.5% in 2008 to 62.5% in 2018. There was large variation in the percentage of residents with full-time providers, with 5.72% of residents in the bottom quintile of facilities to 91.4% in the top quintile.
Citation: Goodwin JS, Agrawal P, Li S . Growth of physicians and nurse practitioners practicing full time in nursing homes. J Am Med Dir Assoc 2021 Dec;22(12):2534-39.e6. doi: 10.1016/j.jamda.2021.06.019..
Keywords: Nursing Homes, Long-Term Care, Provider: Clinician, Provider: Physician, Provider: Nurse, Workforce
Neprash HT, Zink A, Sheridan B
The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care.
Citation: Neprash HT, Zink A, Sheridan B . The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care. J Health Econ 2021 Dec;80:102541. doi: 10.1016/j.jhealeco.2021.102541..
Keywords: Medicare, Healthcare Utilization, Primary Care, Workforce, Health Insurance
Vranas KC, Golden SE, Mathews KS
The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study.
The COVID-19 pandemic resulted in unprecedented adjustments to intensive care unit (ICU) organization and care processes globally. The investigators examined if hospital emergency responses to the COVID-19 pandemic differed depending on hospital setting and explored which strategies worked well to mitigate strain as perceived by intensivists. The investigators concluded that their study demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
Citation: Vranas KC, Golden SE, Mathews KS . The influence of the COVID-19 pandemic on ICU organization, care processes, and frontline clinician experiences: a qualitative study. Chest 2021 Nov;160(5):1714-28. doi: 10.1016/j.chest.2021.05.041..
Keywords: COVID-19, Intensive Care Unit (ICU), Critical Care, Healthcare Delivery, Workforce, Public Health
Kaderka R, Hild SJ, Bry VN, Kaderka R, Hild SJ, Bry VN, , Hild SJ, Bry VN
Wide-scale clinical implementation of knowledge-based planning: an investigation of workforce efficiency, need for post-automation refinement, and data-driven model maintenance.
Investigators sought to investigate the effect of automated knowledge-based planning (KBP) on real-world clinical workflow efficiency, to assess whether manual refinement of KBP plans improves plan quality across multiple disease sites, and to develop a data-driven method to periodically improve KBP automated planning routines. They found that KBP increased clinical efficiency by significantly reducing planning time. On average, human refinement offered minimal dose improvements over KBP-only plans.
Citation: Kaderka R, Hild SJ, Bry VN, Kaderka R, Hild SJ, Bry VN, , Hild SJ, Bry VN . Wide-scale clinical implementation of knowledge-based planning: an investigation of workforce efficiency, need for post-automation refinement, and data-driven model maintenance. Int J Radiat Oncol Biol Phys 2021 Nov 1;111(3):705-15. doi: 10.1016/j.ijrobp.2021.06.028..
Keywords: Workforce, Implementation
Germack HD, Kandrack R, Martsolf GR
Relationship between rural hospital closures and the supply of nurse practitioners and certified registered nurse anesthetists.
This study sought to examine the extent to which rural hospital closures are associated with changes in the NP (nurse practitioner) and CRNA (certified registered nurse anesthetist) workforce. The authors used the Area Health Resources Files (AHRF) data from 2010-2017 to estimate the relationship between rural hospital closures and changes in the supply of NPs and CRNAs. They found 151 hospital closures among 1,544 rural counties. After controlling for local market characteristics, they did not find a significant relationship between hospital closure and the supply of NPs and CRNAs.
Citation: Germack HD, Kandrack R, Martsolf GR . Relationship between rural hospital closures and the supply of nurse practitioners and certified registered nurse anesthetists. Nurs Outlook 2021 Nov-Dec;69(6):945-52. doi: 10.1016/j.outlook.2021.05.005..
Keywords: Provider: Nurse, Workforce, Hospitals
Valbuena VSM, Obayemi JE, Purnell TS
Gender and racial disparities in the transplant surgery workforce.
This review explores trends in the United States (US) transplant surgery workforce with a focus on historical demographics, post-fellowship job market, and quality of life reported by transplant surgeons. Ongoing efforts to improve women and racial/ethnic minority representation in transplant surgery are highlighted in this paper. Future directions to create a transplant workforce that reflects the diversity of the US population are discussed.
AHRQ-funded; HS024600; HS000053.
Citation: Valbuena VSM, Obayemi JE, Purnell TS . Gender and racial disparities in the transplant surgery workforce. Curr Opin Organ Transplant 2021 Oct 1;26(5):560-66. doi: 10.1097/mot.0000000000000915..
Keywords: Workforce, Provider: Physician, Transplantation, Racial / Ethnic Minorities
Marchetti KA, Oerline M, Hollenbeck BK
Urology workforce changes and implications for prostate cancer care among Medicare enrollees.
The purpose of this study was to characterize national trends in urologist workforce, practice organization, and management of incident prostate cancer. The investigators characterized shifts in urologist membership from smaller, independent groups to larger, multispecialty or hospital-owned practices. They indicated that this trend coincided with higher utilization of observation and surgical treatment for prostate cancer.
Citation: Marchetti KA, Oerline M, Hollenbeck BK . Urology workforce changes and implications for prostate cancer care among Medicare enrollees. Urology 2021 Sep;155:77-82. doi: 10.1016/j.urology.2020.12.051..
Keywords: Cancer: Prostate Cancer, Cancer, Workforce, Practice Patterns
Escarce JJ, Wozniak GD, Tsipas S
Effects of the Affordable Care Act Medicaid expansion on the distribution of new general internists across states.
The objective of this study was to determine whether the Medicaid expansion influenced the states selected by physicians just completing graduate medical education for establishing their first practices. Thirty-three states and the District of Columbia expanded Medicaid by the end of the study period. Findings showed that physicians in one specialty group, general internal medicine, were increasingly likely to locate in expansion states after the expansion. The Medicaid expansion influenced the practice location choices of men and international medical graduates in general internal medicine, while women and United States medical graduates did not alter their pre-expansion location patterns. States that opted not to expand Medicaid under the Affordable Care Act lost general internists to expansion states, potentially affecting access to care for all of their residents regardless of insurance coverage.
Citation: Escarce JJ, Wozniak GD, Tsipas S . Effects of the Affordable Care Act Medicaid expansion on the distribution of new general internists across states. Med Care 2021 Jul;59(7):653-60. doi: 10.1097/mlr.0000000000001523..
Keywords: Medicaid, Health Insurance, Provider: Physician, Workforce
Measuring caregiver retention in nursing homes.
This study examined the retention of nursing home caregivers using a survey of nursing home administrators conducted in 2016 from 2,898 facilities. Survey data was matched with Nursing Home Compare and the Certification and Survey Provider Enhanced Reporting data. Four measures of retention were associated with each of three types for caregivers: nurse aids (NAs), registered nurses (RNs), and licensed practical nurses with six quality indicators. Retention rates at 5 years was shown to be low for all three of these caregiver types. Regression estimates showed some support for the theory that different measures of retention were more/less associated with quality. The 3- and 5-year retention measures had the strongest associations with quality of care.
Citation: Castle NG . Measuring caregiver retention in nursing homes. Gerontologist 2021 Jun 2;61(4):e118-e28. doi: 10.1093/geront/gnab012..
Keywords: Nursing Homes, Long-Term Care, Provider: Health Personnel, Workforce
Kandrack R, Barnes H, Martsolf GR
Nurse practitioner scope of practice regulations and nurse practitioner supply.
This study’s objective was to estimate associations between adopting full nurse practitioner (NP) scope of practice (SOP) and improved access to care. The authors used county-level data to estimate the association between adopting full NP SOP and NP supply in general, and in rural and health professional shortage area-designed counties specifically. They estimated positive associations, although the relationship was only statistically significant in health professional shortage areas.
Citation: Kandrack R, Barnes H, Martsolf GR . Nurse practitioner scope of practice regulations and nurse practitioner supply. Med Care Res Rev 2021 Jun;78(3):208-17. doi: 10.1177/1077558719888424..
Keywords: Provider: Nurse, Provider: Clinician, Workforce, Policy
Gettel CJ, Canavan ME, D'Onofrio G
Who provides what care? An analysis of clinical focus among the national emergency care workforce.
This study looked at the clinical focus of emergency department (ED) workers using the 2017 Medicare Public Use Files for clinicians receiving reimbursement for emergency care Evaluation & Management (E/M) services for Medicare fee-for-service Part B. Clinicians were categorized as EM physicians, non-EM physicians, and advanced practice providers (APPs). Of the 65,710 unique clinicians providing care, 59.4% were classified as EM physicians, 12.4% as non-EM physicians, and 28.5% as APPs. EM physicians have twice as much clinician median focus in comparison to EM physicians providing emergency care (92.8% vs 45.2) and APPs are focused 100%.
Citation: Gettel CJ, Canavan ME, D'Onofrio G . Who provides what care? An analysis of clinical focus among the national emergency care workforce. Am J Emerg Med 2021 Apr;42:228-32. doi: 10.1016/j.ajem.2020.11.069..
Keywords: Emergency Department, Workforce, Provider: Physician, Provider: Clinician, Provider, Medicare