Missing in action: Care by physician assistants and nurse practitioners in national health surveys
Missing in action: Care by physician assistants and nurse practitioners in national health surveys
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DOI：
10.1111/j.1475-6773.2007.00700.x
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发表时间：
2007-10-01
影响因子：
3.4
通讯作者：
Albanese, Mark A.
中科院分区：
文献类型：
--
作者：
Morgan, Perri A.;Strand, Justine;Albanese, Mark A.
目标。[目的]评估国家健康调查数据对医生助理(PAS)和护士从业者(NP)关于门诊服务的概括性研究的适用性。方法描述和2003年的数据文件，来自全国非卧床医疗调查、全国医院非卧床医疗调查、医疗费用小组调查和社区跟踪研究。就调查覆盖范围、结构、内容、对美国人口的概括性和有效性进行了调查，以评估对PA和NP患者护理研究的效用。根据调查设计和无反应进行统计调整后的全国患者接诊估计值在不同的调查中进行了比较。数据收集/提取方法。调查是通过文献回顾确定的，根据纳入标准进行选择，并根据方法描述进行分析。定量分析使用从调查网站下载的公开数据。主要发现。关于PA和NP护理的适用性，调查结果各不相同。限制适用性的特征包括(1)采样方案不一致地捕获非医生实践，(2)提供者类型的不准确识别，以及(3)不支持团队实践分析的数据结构。研究人员使用国家卫生保健调查来分析PA和NP患者的相互作用，应该考虑可能对非内科医生数据产生不同影响的设计特征。国家规划工作需要包括NP和PA在内的劳动力研究，这项研究将需要改进调查方法。
Objective. To assess applicability of national health survey data for generalizable research on outpatient care by physician assistants (PAs) and nurse practitioners (NPs).Data Sources. Methodology descriptions and 2003 data files from the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey, the Medical Expenditure Panel Survey, and the Community Tracking Study.Study Design. Surveys were assessed for utility for research on PA and NP patient care, with respect to survey coverage, structure, content, generalizability to the U.S. population, and validity. National estimates of patient encounters, statistically adjusted for survey design and nonresponse, were compared across surveys.Data Collection/Extraction Methods. Surveys were identified through literature review, selected according to inclusion criteria, and analyzed based on methodology descriptions. Quantitative analyses used publicly available data downloaded from survey websites.Principal Findings. Surveys varied with respect to applicability to PA and NP care. Features limiting applicability included (1) sampling schemes that inconsistently capture nonphysician practice, (2) inaccurate identification of provider type, and (3) data structure that does not support analysis of team practice.Conclusions. Researchers using national health care surveys to analyze PA and NP patient interactions should account for design features that may differentially affect nonphysician data. Workforce research that includes NPs and PAs is needed for national planning efforts, and this research will require improved survey methodologies.