Factors associated with the use of advanced practice nurses/physician assistants in a fee-for-service nursing home practice: A comparison with primary care physicians

Debra Bakerjian, Charlene Harrington

Research output: Contribution to journalArticle

7 Scopus citations


The purpose of this research was to examine factors associated with the use of advanced practice nurse and physician assistant (APN/PA) visits to nursing home (NH) patients compared with those by primary care physicians (PCPs). This was a secondary analysis using Medicare claims data. General estimation equations were used to determine the odds of NH residents receiving APN/PA visits. Ordinary least squares analyses were used to examine factors associated with these visits. A total of 5,436 APN/PAs provided care to 27% of 129,812 residents and were responsible for 16% of the 1.1 million Medicare NH fee- for-service visits in 2004. APN/PAs made an average of 33 visits annually compared with PCPs (21 visits). Neuropsychiatric and acute diagnoses and patients with a long-stay status were associated with more APN/PA visits. APN/PAs provide a substantial amount of care, but regional variations occur, and Medicare regulations constrain the ability of APN/PAs to substitute for physician visits.

Original languageEnglish (US)
Pages (from-to)163-173
Number of pages11
JournalResearch in gerontological nursing
Issue number3
StatePublished - 2012


ASJC Scopus subject areas

  • Gerontology
  • Health Policy
  • Geriatrics and Gerontology

Cite this