Are older patients satisfied with physician assistants and nurse practitioners?

To determine how satisfied older American consumers are with physician assistant (PA) and nurse practitioner (NP) care.

Cross-sectional national survey.

Noninstitutional, representative random sample of people aged 65 years and older.

Medicare recipients from the 2000 and 2001 Medicare Satisfaction Survey, Consumer Assessment of Health Plans Survey section on Fee-for-Service, who identified a primary care provider.

Patient sociodemographic characteristics, health care experience, and satisfaction data were compared in which a generalist physician, PA, or NP was identified as the personal provider.

146,880 completed returns from 321,407 randomly sampled Medicare beneficiaries nationwide (45.7% of the total surveyed) were analyzed with regard to satisfaction with their personal providers. Of this number, 3,770 identified a PA or an NP as their personal provider. For questions on satisfaction with their personal care clinician, results were similar for all three kinds of providers. A significantly higher proportion of the patients who reported NPs as their primary care providers were Medicaid recipients than were those patients who reported receiving care from PAs or physicians. Conversely, a significantly higher proportion of patients who were supplemental insurance recipients reported physicians as their primary care providers than were those who reported receiving care from PAs or NPs.

Findings suggest that patients are generally satisfied with their medical care and do not distinguish preferences based on types of providers. PAs, NPs, and physicians in primary care seemed to be viewed similarly regardless of patient characteristics. PAs and NPs may be a workforce that could be expanded to care for the rising needs of the elderly.