Trend Continues: More Full-Time Clinicians in Nursing Homes
Full-time clinicians in nursing homes (NHs) are a growing trend, according to a new study in the December issue of JAMDA. The percentage of clinicians—physicians, nurse practitioners (NPs), and physical assistants (PAs)— who worked full-time in NHs increased from 26% in 2008 to 45% in 2017. The largest increase involved NPs, from 1,986 of these practitioners working as full-time NH clinicians to 4,479 during the study period.
In Growth of Physicians and Nurse Practitioners Practicing Full Time in Nursing Homes, the authors found that the major determinants of whether residents had a full-time nursing home clinician is the NH where they reside. “Residents in larger, urban, for-profit, and minority-serving nursing homes had higher odds of having a full-time nursing home provider,” the authors said, “but these nursing home characteristics explained little of the variation among facilities.” There was considerable variation from facility to facility, they noted. In fact, they said, the degree of variation was much higher than they expected.
The percentage of NH residents with access to full-time clinicians continues to grow, the authors said; and this trend has several advantages. One major rationale, they observed, is that it tends to promote both quality and efficiency. Additionally, they suggested, full-time clinicians “should provide better coverage to evaluate and intervene early after changes in clinical status.” They also noted that previous studies have found that NH or other long-term care facility residents with full-time clinicians have fewer avoidable hospitalizations and lower annual Medicare spending.
This study was conducted by researchers at the Sealy Center on Aging, Department of Medicine, School of Medicine, and Department of Preventive Medicine and Population Health, The University of Texas Medical Branch at Galveston, TX.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.