Nurse Practitioners Prevent Hospital Admissions Among Diabetics

Nurse practitioners are comparable with primary care physicians in curbing preventable hospitalizations among older patients with diabetes.

Patients with chronic conditions like diabetes are encouraged to seek regular primary care to avoid unnecessary hospital admissions.

In light of the shortage of primary care physicians, more and more patients are turning to nurse practitioners for their regular primary care visits. In fact, the number of Medicare patients receiving primary care from nurse practitioners increased 15-fold between 1998 and 2010.

But patients receiving all of their primary care from nurse practitioners have raised concerns among some medical groups, which have argued that health outcomes for these patients may differ from those who receive primary care from physicians.

To put this opposing theory to the test, researchers from the University of Texas Medical Branch at Galveston compared the rate of potentially preventable hospitalizations among patients who received all primary care from nurse practitioners with those who received primary care from physicians.

From a national sample of Medicare beneficiaries, the researchers identified 345,819 older patients with diabetes who received all primary care from nurse practitioners or generalist physicians in a given year.

Using potentially preventable hospitalizations as a quality indicator, the researchers concluded that primary care provided by nurse practitioners was “at least comparable with that provided by generalist physicians.”

In fact, “older diabetic patients who received all of their primary care from nurse practitioners had lower rates of potentially preventable hospitalization than those who received primary care from physicians in nonmetropolitan urban and rural areas,” said lead study author Yong-Fang Kuo, PhD, in a press release.

Dr. Kuo noted that this particular discovery in nonmetropolitan areas is important, given that there has been a shortage of physicians in rural areas for the past 3 decades. Those who do practice in rural areas may have a larger patient load, limiting their ability to spend sufficient time with patients or follow-up with them.

“In view of the growing role of nurse practitioners in the US health care system, information on the quality of nurse practitioner care holds broad clinical and public health relevance,” Dr. Kuo stated. “…These findings support previous research suggesting that nurse practitioners provide the same quality of clinical care as physicians.”

The previous research Dr. Kuo pointed to has shown that nurse practitioners spend more time with patients, give patients more information, and follow-up more frequently than primary care physicians.

The current study was titled “Potentially Preventable Hospitalizations in Medicare Patients With Diabetes: A Comparison of Primary Care Provided by Nurse Practitioners Versus Physicians” and published in the September 2015 issue ofMedical Care.