Understanding the Role of Advanced Practice Providers in Oncology in the United States
Understanding the Role of Advanced Practice Providers in Oncology in the United States
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DOI：
10.1200/jop.18.00181
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发表时间：
2018-09-01
影响因子：
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通讯作者：
Williams, Stephanie F.
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文献类型：
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作者：
Bruinooge, Suanna S.;Pickard, Todd A.;Williams, Stephanie F.
目的：高级实践提供者(APP，包括护士从业者[NPs]和医生助理[PA])是肿瘤学团队不可或缺的成员。本研究旨在首先识别所有肿瘤学APP，其次了解这些APP的个人和实践特征(包括补偿)。方法：我们从会员和索赔数据中识别出从事肿瘤学的应用程序。我们调查了3055个应用程序在临床护理中的角色。结果：我们确定了至少5350个肿瘤学应用程序和另外5400个可能从事肿瘤学工作的应用程序。调查受访者总数为577人，回复率为19%。结果集中在540个NP和PA上。超过90%的受访者表示对职业选择感到满意。受访者认为主要是白人(%)和女性(94%)。NPS和PAS将大部分时间(80%)用于直接患者护理。排在前四位的患者护理活动是：患者咨询(NPS，94%；PAS，98%)、处方(NPS，93%；PAS，97%)、治疗管理(NPS，89%；PAS，93%)和随访(NPS，81%；PAS，86%)。大多数APP报告了独立访问和共享访问(65%的hematology/oncology/survivorship/prevention/pediatric血液科/肿瘤科；85%的外科/妇科肿瘤科；78%的放射肿瘤科)。少数应用程序报告称，它们只进行共享访问。平均年薪在11.3万美元到11.5万美元之间，比非肿瘤学APP的平均薪酬高出约1万美元。结论：我们确定了5350个肿瘤学应用程序，并得出结论，这个数字可能高达7000个。调查结果表明，整合应用程序的做法通常依赖于它们来照顾病人。鉴于癌症患者和幸存者的数量不断增加，应用程序对于确保现在和未来获得高质量的癌症护理非常重要。
Purpose:Advanced practice providers (APPs, which include nurse practitioners [NPs] and physician assistants [PAs]) are integral members of oncology teams. This study aims first to identify all oncology APPs and, second, to understand personal and practice characteristics (including compensation) of those APPs.Methods:We identified APPs who practice oncology from membership and claims data. We surveyed 3,055 APPs about their roles in clinical care.Results:We identified at least 5,350 APPs in oncology and an additional 5,400 who might practice oncology. Survey respondents totaled 577, which provided a 19% response rate. Results focused on 540 NPs and PAs. Greater than 90% reported satisfaction with career choice. Respondents identified predominately as white (89%) and female (94%). NPs and PAs spent the majority (80%) of time in direct patient care. The top four patient care activities were patient counseling (NPs, 94%; PAs, 98%), prescribing (NPs, 93%; PAs, 97%), treatment management (NPs, 89%; PAs, 93%), and follow-up visits (NPs, 81%; PAs, 86%). A majority of all APPs reported both independent and shared visits (65% hematology/oncology/survivorship/prevention/pediatric hematology/oncology; 85% surgical/gynecologic oncology; 78% radiation oncology). A minority of APPs reported that they conducted only shared visits. Average annual compensation was between $113,000 and $115,000, which is approximately $10,000 higher than average pay for nononcology APPs.Conclusion:We identified 5,350 oncology APPs and conclude that number may be as high as 7,000. Survey results suggest that practices that incorporate APPs routinely rely on them for patient care. Given the increasing number of patients with and survivors of cancer, APPs are important to ensure access to quality cancer care now and in the future.