Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-06-25T11:07:35 RDF description of Quality of diabetes care in family medicine practices: influence of nurse-practitioners and physician's assistants - http://repository.healthpartners.com/individual/document-rn18983 Comparative Studies 1 25466 public Annals of Family Medicine 6 15443 Quality of Health Care Patient Care Team document-rn18983 Physicians' Practice Patterns Cross-Sectional Studies Quality of diabetes care in family medicine practices: influence of nurse-practitioners and physician's assistants Nurses Comorbidity <p>PURPOSE: The aim of this study was to assess whether the quality of diabetes care differs among practices employing nurse-practitioners (NPs), physician's assistants (PAs), or neither, and which practice attributes contribute to any differences in care. METHODS: This cross-sectional study of 46 family medicine practices from New Jersey and Pennsylvania measured adherence to American Diabetes Association diabetes guidelines via chart audits of 846 patients with diabetes. Practice characteristics were identified by staff surveys. Hierarchical models determined differences between practices with and without NPs or PAs. RESULTS: Compared with practices employing PAs, practices employing NPs were more likely to measure hemoglobin A(1c) levels (66% vs 33%), lipid levels (80% vs 58%), and urinary microalbumin levels (32% vs 6%); to have treated for high lipid levels (77% vs 56%); and to have patients attain lipid targets (54% vs 37%) (P <or= .005 for each). Practices with NPs were more likely than physician-only practices to assess hemoglobin A(1c) levels (66% vs 49%) and lipid levels (80% vs 68%) (P<or=.007 for each). These effects could not be attributed to use of diabetes registries, health risk assessments, nurses for counseling, or patient reminder systems. Practices with either PAs or NPs were perceived as busier (P=.03) and had larger total staff (P <.001) than physician-only practices. CONCLUSIONS: Family practices employing NPs performed better than those with physicians only and those employing PAs, especially with regard to diabetes process measures. The reasons for these differences are not clear.<p> 2022-02-21T22:48:57.408-06:00 Randomized Controlled Trials Diabetes Family Practice 10.1370/afm.758