Characteristics of primary care office visits to nurse practitioners, physician assistants and physicians in United States Veterans Health Administration facilities, 2005 to 2010: a retrospective cross-sectional analysis.

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.

The hosiery industry: Report on the cost of production of hosiery in the United States

At head of title: Department of Commerce. Bureau of Foreign and Domestic Commerce. E.E. Pratt, Chief ...

The knit-underwear industry: Report on the cost of production of knit underwear in the United States

At head of title: Department of Commerce. Bureau of Foreign and Domestic Commerce. E.E. Pratt, Chief ...

The women's muslin-underwear industry: report on the cost of production of women's muslin underwear in the United States

Department of Commerce, Bureau of Foreign and Domestic Commerce.

Index of all reports issued by Bureaus of Labor Statistics in the United States, prior to March 1, 1902

prepared under the direction of Carroll D. Wright ; for the use of the United States Department of Labor.

1974 census of agriculture : Virgin Islands of the United States /

Vol. 1, pt. 54 of the 1974 census of agriculture.

Preliminary review of existing studies of the number of illegal residents in the United States /

Caption title.

Trade of the United States with Cuba in ... /

"Prepared by the Divisions of Regional Information and Business Review in cooperation with the Division of Foreign Trade Statistics."

Census of the Virgin islands of the United States, November 1, 1917. /

"The section of the report relating to population was prepared by Dr. Alba M. Edwards, expert special agent of the Division of population, and the section relating to agriculture was prepared by Mr. Arthur J. Hirsch, expert special agent of the Division of agriculture". -p. 9.

Statistical abstract of the United States, 1988 : national data book and guide to sources.

Chiefly tables.

Estimates of illegal aliens from Mexico counted in the 1980 United States census /

"A paper presented at the annual meeting of the Population Association of America, Pittsburgh, Pennsylvania, April 14-16, 1983."

[Persons of Hispanic origin in the United States, 1990 /

"These tables present 1990 census estimates of 28 Hispanic origin groups, based on sample tabulations, for the United States and each state"--Letter of transmittal.

Fifteenth census of the United States: 1930. Metropolitan districts. Population and area.

Forms part of the series of Reports of the Fifteenth decennial census

The history of the Chaplain Corps, United States Navy

Vol. 4-5 compiled by the Chaplains Division of the Bureau of Naval Personnel, Navy Dept.; v. 7 by the staff and students of the Naval Chaplains School, Naval Officer Training Center; v. 8-<9 > edited by H. Lawrence Martin.

Official register of the United States : persons in the civil, military, and naval service, exclusive of the Postal Service /

Subtitle varies.