Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec 1;16(12):e343-55.

Nurse practitioner comanagement for patients in an academic geriatric practice

David A Ganz  1 , Brandon K Koretz, Julia K Bail, Heather E McCreath, Neil S Wenger, Carol P Roth, David B Reuben
Affiliations

Nurse practitioner comanagement for patients in an academic geriatric practice

David A Ganz et al. Am J Manag Care. .

Abstract

Objective: To determine whether nurse practitioner (NP) comanagement can improve the quality of care for 5 chronic conditions in an academic geriatrics practice.

Study design and methods: From September 2006 to September 2007, 18 primary care geriatricians were divided into an intervention group that could refer patients to an NP for comanagement of dementia, depression, falls, heart failure, and/or urinary incontinence, or a control group that indicated which patients would have been referred to the NP for these conditions. The NP used structured visit notes to guide care delivery for the 5 conditions concordant with Assessing Care of Vulnerable Elders-3 (ACOVE-3) quality indicators. We reviewed charts to determine adherence to recommended processes of care.

Results: A total of 200 patients (108 intervention, 92 control) were eligible for at least 1 process of care recommended by ACOVE-3 for the 5 conditions. Patients' mean (SD) age was 85 years (7 years), 67% were women, and patients were eligible for a mean (SD) of 6.9 (4.4) processes of care. Intervention patients were eligible for more care processes than controls (7.8 vs 5.9 processes per patient; P = .002). Quality of care was higher for patients in the intervention group compared with the control group (54% vs 34% of care processes completed; P <.001). The adjusted absolute difference between intervention and control groups in care processes completed was 20% (95% confidence interval = 13%, 27%).

Conclusion: NP comanagement of 5 chronic conditions was associated with higher quality of care, even in a practice of geriatricians.

PubMed Disclaimer

Conflict of interest statement

None of the authors has a conflict of interest relevant to this manuscript.

References

    1. Hauer KE, Durning SJ, Kernan WN, et al. Factors associated with medical students’ career choices regarding internal medicine. JAMA. 2008 Sep 10;300(10):1154–1164. - PubMed
    1. Steinbrook R. Easing the shortage in adult primary care--is it all about money? N Engl J Med. 2009 Jun 25;360(26):2696–2699. - PubMed
    1. Institute of Medicine (U.S.). Committee on the Future Health Care Workforce for Older Americans. Retooling for an aging America: building the health care workforce. Washington, D.C: National Academies Press; 2008. - PubMed
    1. Goroll AH, Berenson RA, Schoenbaum SC, Gardner LB. Fundamental reform of payment for adult primary care: comprehensive payment for comprehensive care. J Gen Intern Med. 2007 Mar;22(3):410–415. - PMC - PubMed
    1. Ganz DA, Fung CH, Sinsky CA, Wu S, Reuben DB. Key Elements of High-Quality Primary Care for Vulnerable Elders. J Gen Intern Med. 2008 Oct 7; - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources