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The effect of primary care clinician type and care team characteristics on health care costs.
Bernard, Matthew E; Halasy, Michael P; Rushlow, David R; Sobolik, Gerald J; Garrison, Gregory M; Matthews, Marc R; Allen, Summer V; Thacher, Thomas D.
Afiliação
  • Bernard ME; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Halasy MP; Spine Center, Rochester, Minnesota, USA.
  • Rushlow DR; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Sobolik GJ; Employee and Community Health, Primary Care and Population Health, Rochester, Minnesota, USA.
  • Garrison GM; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Matthews MR; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Allen SV; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Thacher TD; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, USA.
J Eval Clin Pract ; 28(6): 1055-1060, 2022 12.
Article em En | MEDLINE | ID: mdl-35434886
ABSTRACT

OBJECTIVE:

To evaluate health care costs as a function of assigned primary care clinician type and care team characteristics.

METHODS:

Administrative data were collected for 68 family medicine clinicians (40 physicians and 28 nurse practitioners [NPs]/physician assistant [PAs]), on 11 care teams (variable MD, NP and PA on teams), caring for 77,141 patients. We performed a generalized linear mixed multivariable regression model of standardized per member per month (PMPM) median cost as the outcome, with four practice sites included as random effects.

RESULTS:

In bivariate analysis, cost was higher in physicians than NP/PAs, in more complex patients, and associated with emergency department (ED) visit rate. On multivariate analysis, patient complexity, ED visit rate and higher patient experience ratings were independently associated with greater PMPM cost. More time in practice was associated with lower PMPM cost. In the adjusted multivariate model, physicians had 8.3% lower median PMPM costs than NP/PAs (p = 0.046).

CONCLUSIONS:

The primary drivers of greater PMPM cost were patient complexity, ED visits and patient satisfaction.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Assistentes Médicos / Profissionais de Enfermagem Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Assistentes Médicos / Profissionais de Enfermagem Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos