The Role of Nurse Practitioners in Improving Access to Primary Care
执业护士在改善初级保健机会方面的作用
基本信息
- 批准号:10595008
- 负责人:
- 金额:$ 4.94万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-04-01 至 2024-03-31
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Project Summary/Abstract: This proposal responds to AHRQ’s Special Emphasis Notice (NOT-HS-16-011)
highlighting their ongoing interest in receiving applications related to innovative primary care research.
Inequitable access to high-quality primary care is one factor contributing to disparities in ambulatory care-
sensitive health conditions. As primary care changes rapidly to include nurse practitioners (NPs), limited
evidence suggests NPs as a potential mechanism for improving access to primary care. Compared to
physicians, NPs are more likely to treat patients of color, patients covered by Medicaid, and uninsured patients.
This proposed research will provide the first empirical evidence quantifying changes in access to primary
care – particularly for patient populations historically facing access challenges – after group practices employ
an NP. To do so, we propose using a database of all-payer claims and electronic health record data with a
nationwide sample of primary care clinicians. This dataset allows us to overcome three data challenges that
have hindered research on this topic. First, we accurately observe who provided health care services – which
is frequently distinct from who billed for the care. Second, we observe scheduling data, allowing us to construct
objective measures of access such as visit wait time and share of visits provided to new patients. Third and
finally, we observe all care provided by clinicians within our sample, regardless of payer status – allowing us to
compare measures of access across patient populations (i.e., access for Medicaid patients compared to
commercially-insured patients). Dr. Neprash (PI) has access to and has published extensively with the
proposed data source, including work focused on primary care NPs.
In Aim 1, we will quantify changes in access to care for new patients, after an NP joins a primary care
practice. Outcomes include the share of visits provided to new patients (i.e., those not previously treated at the
practice), with a particular focus on new Medicaid or uninsured patients and new patients self-identifying as
Black, Indigenous, and people of color.
In Aim 2, we will quantify overall changes in access to and convenience of care, after an NP joins a
practice. Outcomes include visit wait time (i.e., days elapsed between visit scheduling and visit occurrence),
the share of visits provided on a walk-in basis, and the share of visits provided on evenings and weekends.
This pilot study will provide the first evidence on how access to care – particularly for AHRQ priority
populations – changes when primary care practices employ a nurse practitioner. As NPs become increasingly
prevalent within primary care practices, it is crucial to understand the role they play in potentially expanding
access to primary care services and providing high-quality, efficient care. This small grant proposal represents
the first step in a broader research agenda of understanding the roles that NPs play in reducing health
disparities.
项目概要/摘要:本提案响应AHRQ的特别强调通知(NOT-HS-16-011)
强调他们对接收与创新初级保健研究相关的申请的持续兴趣。
获得高质量初级保健的机会不平等是造成门诊护理不平等的一个因素,
敏感的健康状况。由于初级保健迅速变化,包括执业护士(NP),有限
有证据表明,国家方案是改善获得初级保健的一种潜在机制。相比
医生,NPs更有可能治疗有色人种患者,医疗补助覆盖的患者和无保险的患者。
这项拟议中的研究将提供第一个实证证据,量化获得初级教育的变化,
护理-特别是对于历史上面临访问挑战的患者群体-在小组实践采用
一个NP为此,我们建议使用所有付款人索赔和电子健康记录数据的数据库,
全国范围内的初级保健临床医生样本。这个数据集使我们能够克服三个数据挑战,
阻碍了对这一课题的研究。首先,我们准确地观察谁提供了医疗保健服务--
通常与为护理付费的人不同。其次,我们观察调度数据,使我们能够构建
客观衡量获得服务的机会,如就诊等待时间和向新病人提供就诊的比例。三和
最后,我们观察了样本中临床医生提供的所有护理,无论付款人身份如何,这使我们能够
比较患者群体之间的访问度量(即,与医疗补助患者相比,
商业保险患者)。Neprash博士(PI)可以访问并广泛发表
建议的数据来源,包括重点关注初级保健NP的工作。
在目标1中,我们将量化NP加入初级保健后新患者获得护理的变化
实践结果包括为新患者提供的就诊份额(即,那些以前没有接受过治疗的人
实践),特别关注新的医疗补助或无保险的患者和新患者自我识别为
黑人,土著人和有色人种。
在目标2中,我们将量化一个NP加入一个NP后,
实践结果包括访问等待时间(即,访视安排和访视发生之间的天数),
无预约探访的比例以及晚上和周末探访的比例。
这项试点研究将提供第一个证据,说明如何获得护理-特别是AHRQ的优先事项
人口-初级保健做法雇用执业护士时的变化。随着NPs越来越多
在初级保健实践中普遍存在,关键是要了解他们在潜在的扩大
获得初级保健服务和提供高质量、高效率的护理。这一小笔赠款提案代表了
这是更广泛的研究议程的第一步,即了解纳米颗粒在减少健康方面的作用,
差距。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Hannah Toby Neprash其他文献
Hannah Toby Neprash的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Hannah Toby Neprash', 18)}}的其他基金
The Role of Nurse Practitioners in Improving Access to Primary Care
执业护士在改善初级保健机会方面的作用
- 批准号:
10450283 - 财政年份:2022
- 资助金额:
$ 4.94万 - 项目类别:
Payment Increases and Physician Supply of Care for Medicaid Beneficiaries
医疗补助受益人的付款增加和医生护理供应
- 批准号:
9061192 - 财政年份:2015
- 资助金额:
$ 4.94万 - 项目类别:
相似海外基金
The Role of Nurse Practitioners in Improving Access to Primary Care
执业护士在改善初级保健机会方面的作用
- 批准号:
10450283 - 财政年份:2022
- 资助金额:
$ 4.94万 - 项目类别:
Research on the Improvement of Clinical Reasoning Skills of Nurse practitioners and Certified Nurse Specialists Using of a Clinical Decision Support System for Neonates
使用新生儿临床决策支持系统提高执业护士和注册护士专家的临床推理能力的研究
- 批准号:
22K11075 - 财政年份:2022
- 资助金额:
$ 4.94万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Building care models by interprofessional collaboration of nurse practitioners in the primary care
通过初级保健执业护士的跨专业合作建立护理模式
- 批准号:
21K10986 - 财政年份:2021
- 资助金额:
$ 4.94万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Advancement of Research on Nurse Practitioners (ARNP): Setting a Research Agenda
执业护士研究进展(ARNP):制定研究议程
- 批准号:
10088080 - 财政年份:2020
- 资助金额:
$ 4.94万 - 项目类别:
RADECT is developing a clinical guidance (CG) software for nurse education and practitioners to evaluate experiential case-files for the purpose of augmenting health disparity/equity clinical care.
RADECT 正在为护士教育和从业人员开发临床指导 (CG) 软件,以评估经验病例档案,以扩大健康差距/公平临床护理。
- 批准号:
9796210 - 财政年份:2019
- 资助金额:
$ 4.94万 - 项目类别:
Development of a home care transition support system to strengthen symptom management by nurse practitioners
开发家庭护理过渡支持系统,以加强执业护士的症状管理
- 批准号:
19K19532 - 财政年份:2019
- 资助金额:
$ 4.94万 - 项目类别:
Grant-in-Aid for Early-Career Scientists
RADECT is developing a clinical guidance (CG) software for nurse education and practitioners to evaluate experiential case-files for the purpose of augmenting health disparity/equity clinical care.
RADECT 正在为护士教育和从业人员开发临床指导 (CG) 软件,以评估经验病例档案,以扩大健康差距/公平临床护理。
- 批准号:
10038114 - 财政年份:2019
- 资助金额:
$ 4.94万 - 项目类别:
Research on the Creation of Visiting Nurse Practitioners System for Children Requiring Medical Homecare
为需要医疗家庭护理的儿童创建上门执业护士制度的研究
- 批准号:
17K19862 - 财政年份:2017
- 资助金额:
$ 4.94万 - 项目类别:
Grant-in-Aid for Challenging Research (Exploratory)
Clinical Judgment and Decision Making Process of Japanese Nurse Practitioners
日本执业护士的临床判断和决策过程
- 批准号:
17H07309 - 财政年份:2017
- 资助金额:
$ 4.94万 - 项目类别:
Grant-in-Aid for Research Activity Start-up
Multiple-Case Study of Primary Healthcare Teams with Nurse Practitioners in an Integrated Healthcare System
综合医疗保健系统中初级医疗保健团队与执业护士的多案例研究
- 批准号:
343401 - 财政年份:2016
- 资助金额:
$ 4.94万 - 项目类别:
Operating Grants