CHARACTERISTICS OF PATIENT VISITS TO NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS IN-HOSPITAL OUTPATIENT DEPARTMENTS

Many authors have described differences between nurse practitioners an d physician assistants. Most studies have compared physician with nonp hysician providers' practice. Few studies have compared nurse practiti oners and physician assistants, and none has used a national data base . This exploratory, atheoretical research examined which of the follow ing characteristics predicted patients being seen by nurse practitione rs and physician assistants: patient and hospital demographics, diagno sis, diagnostic/screening services, therapeutic services, and disposit ion of the visit. The data set used for analysis was the 1992 National Hospital Ambulatory Medical Care Survey. Based on a multistage probab ility design yielding national estimates for patient visits in hospita l outpatient settings, the National Hospital Ambulatory Medical Care S urvey showed that there were 2,847 weighted patient visits to either n urse practitioners or physician assistants (4.6 million patient visits using national estimates). Results of multivariate logistic regressio n suggest that nurse practitioners were the most likely nonphysician p rovider for outpatients receiving more health promotion and counseling (therapeutic) services and for those needing women's and children's s ervices. Outpatients in rural areas predicted visits to physician assi stants. As more nonphysician providers enter the work force, the resul ts of this research may assist with understanding the utilization of n urse practitioners and physician assistants in primary care. Copyright (C) 1998 by W.B. Saunders Company.