Optimal Staffing Models To Care For Frail Older Adults In Primary Care And Geriatrics Practices In The US.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Geriatric Care

Background:

• The growing population of older adults necessitates efficient and high-quality primary and geriatric care services.
• Staffing configurations in healthcare practices can significantly impact service delivery and quality.

Purpose of the Study:

• To assess the association between different staffing models (physician-dominated vs. NP/PA-heavy vs. team-based) and primary care performance measures.
• To identify optimal practice configurations for delivering comprehensive care to older adults.

Main Methods:

• Analysis of 2018 survey data from physicians (MDs) and nurse practitioners (NPs) in primary and geriatric care settings.
• Comparison of performance on standard process measures across different provider mix configurations.

Main Results:

• Practices with a high concentration of MDs incurred the highest labor costs.
• High-NP/PA configurations were linked to a 17% higher probability of facilitating patient visits and a 26% higher probability of providing comprehensive primary care services compared to high-MD models.
• Team-based configurations showed a 27.7% greater probability of delivering the full spectrum of primary care services.

Conclusions:

• Team-based primary care models with a diverse provider mix, including NPs and PAs, are associated with better performance in delivering comprehensive services.
• These diverse staffing models may be best suited to meet the complex needs of the aging population, offering integrated care both in-office and in the community.