Understanding Why Nurse Practitioner (NP) and Physician Assistant (PA) Productivity Varies Across Community Health Centers (CHCs): A Comparative Qualitative Analysis

Understanding Why Nurse Practitioner (NP) and Physician Assistant (PA) Productivity Varies Across Community Health Centers (CHCs): A Comparative Qualitative Analysis

This study asks how much and why the productivity of advanced practice clinicians (APCs; nurse practitioners and physician assistants) varies across community health centers (CHCs), as measured in their marginal contribution to overall patient visits. We found APCs in the 90th percentile CHCs provid...

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Bibliographic Details
Published in:Medical care research and review Vol. 78; no. 1_suppl; pp. 18S - 29S
Main Authors: Pittman, Patricia, Park, Jeongyoun, Bass, Emily, Luo, Qian “Eric”
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01-02-2021
SAGE PUBLICATIONS, INC
Subjects:
Advanced practice nurses
Assistants
Community health services
Comparative analysis
Content analysis
Doctors' assistants
Educational programs
Financial incentives
Health care facilities
Health education
Health facilities
Health services
Incentives
Leadership
Medical personnel
Nurse practitioners
Physician assistants
Physicians
Productivity
Qualitative analysis
Qualitative research
Visits
qualitative comparative analysis
nurse practitioners
productivity
physician assistants
primary care
workforce
production function
community health centers
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Summary:This study asks how much and why the productivity of advanced practice clinicians (APCs; nurse practitioners and physician assistants) varies across community health centers (CHCs), as measured in their marginal contribution to overall patient visits. We found APCs in the 90th percentile CHCs provide about 1,840 adjusted-visits per year, whereas APCs in the 10th percentile CHCs provide about 978 adjusted-visits per year. We interviewed leadership at 14 high APC and 16 low APC productivity CHCs to elicit organizational conditions that could explain the difference. Using content analysis and then qualitative comparative analysis, we found several important conditions were more common among high productivity CHCs, including scheduling APCs and physicians for the same number of visits, parity in terms of any financial incentives, and formal education programs for new APCs during onboarding/transition to practice.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:1077-5587
1552-6801
DOI:10.1177/1077558720960893