3 resultados para Illinois Office of Education. Dept. of Planning, Research, and Evaluation. Research and Statistics Section
em Duke University
Resumo:
UNLABELLED: BACKGROUND: Primary care, an essential determinant of health system equity, efficiency, and effectiveness, is threatened by inadequate supply and distribution of the provider workforce. The Veterans Health Administration (VHA) has been a frontrunner in the use of nurse practitioners (NPs) and physician assistants (PAs). Evaluation of the roles and impact of NPs and PAs in the VHA is critical to ensuring optimal care for veterans and may inform best practices for use of PAs and NPs in other settings around the world. The purpose of this study was to characterize the use of NPs and PAs in VHA primary care and to examine whether their patients and patient care activities were, on average, less medically complex than those of physicians. METHODS: This is a retrospective cross-sectional analysis of administrative data from VHA primary care encounters between 2005 and 2010. Patient and patient encounter characteristics were compared across provider types (PA, NP, and physician). RESULTS: NPs and PAs attend about 30% of all VHA primary care encounters. NPs, PAs, and physicians fill similar roles in VHA primary care, but patients of PAs and NPs are slightly less complex than those of physicians, and PAs attend a higher proportion of visits for the purpose of determining eligibility for benefits. CONCLUSIONS: This study demonstrates that a highly successful nationwide primary care system relies on NPs and PAs to provide over one quarter of primary care visits, and that these visits are similar to those of physicians with regard to patient and encounter characteristics. These findings can inform health workforce solutions to physician shortages in the USA and around the world. Future research should compare the quality and costs associated with various combinations of providers and allocations of patient care work, and should elucidate the approaches that maximize quality and efficiency.
Resumo:
© 2015, Jon C. Giullian and Ernest A. Zitser.The proliferation of research guides created using the LibGuides platform has triggered extensive discussion touting their benefits for everything from assessment, engagement, and marketing, to outreach and pedagogy. However, there is at present a relative paucity of critical reflection about the product’s place in the broader informational landscape. This article is an attempt to redress this lacuna. Relying primarily on examples from the field of Slavic, East European, and Eurasian studies, the authors briefly describe the evolution of online research guides; identify reasons for the proliferation of Springshare’s product in academic libraries; question whether LibGuides improve learning or reinforce information inequality in higher education; and propose a way to move beyond LibGuides.