Nurse Practitioners Providing Most House Calls to Older Adults
Nurse practitioners (NPs) are now the largest group of care professionals providing house calls for frail, homebound older adults, according to new research; however, researchers said nursing facility residents are more likely to receive NP home care than older adults still living in their own homes, according to an article in the Journal of the American Geriatrics Society (2016; doi:10.1111/jgs.14698).
For the study, Nengliang “Aaron” Yao, PhD (University of Virginia, Charlottesville, VA), and colleagues analyzed the data of Medicare beneficiaries from 2012 and 2013; they measured Medicare payments for home and domiciliary care visits, the number of residence-based medical visits, provider volume, and geographical distribution of full-time house call providers.
Researchers found that, in 2013, NPs provided more than 1.13 million home visits, surpassing the 1.08 million made by internal medicine doctors. That is the reverse of 2012, when internal medicine doctors made 1.08 million visits and NPs made fewer than 925,000. Also, nursing home residents were far more likely to receive house calls than were people still living in their own residences.
These findings have “implications for both house-call providers and nursing education…If we want to take care of our geriatric population, we really need more providers to do so,” said Dr Yao.
While the number of new doctors licensed each year is capped by the number of medical residencies available, there is no similar limit on NPs. But regulations in many states are limiting the growth of that field as well; by revisiting those rules, Dr Yao said, state governments could help address some of their residents’ unmet medical needs.
Researchers also found that the total number of home visits made by all specialties grew from 4.9 million to almost 5.2 million. In addition, NPs provided care over the largest geographic area; the bulk of NPs who made more than 1000 house calls in 2013 were in the eastern half of the United States, with the strongest concentration in the Northeast.—Amanda Del Signore
