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[Preprint]. 2024 Mar 14:rs.3.rs-3972673.
doi: 10.21203/rs.3.rs-3972673/v1.

Racial and ethnic disparities in ED use among older adults with asthma and primary care nurse practitioner work environments

Lusine Poghosyan  1 , Jianfang Liu  1 , Eleanor Turi  2 , Kathleen Flandrick  1 , Marcia Robinson  1 , Maureen George  3 , Grant Martsolf  4 , J Margo Brooks Carthon  5 , Monica O'Reilly-Jacob  1
Affiliations

Racial and ethnic disparities in ED use among older adults with asthma and primary care nurse practitioner work environments

Lusine Poghosyan et al. Res Sq. .

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Abstract

Background: Nurse practitioners (NPs) increasingly deliver primary care in the United States. Yet, poor working conditions strain NP care. We examined whether racial/ethnic health disparities in ED visits among older adults with asthma are moderated by primary care NP work environments.

Methods: Survey data on NP work environments in six states were collected from 1,244 NPs in 2018-2019. 2018 Medicare claims data from 46,658 patients with asthma was merged with survey data to assess the associations of all-cause and ambulatory care sensitive conditions (ACSC) ED visits with NP work environment and race/ethnicity using logistic regression.

Results: NP work environment moderated the association of race (Black patients versus White patients) with all-cause (odds ratio [OR]: 0.91; p-value = 0.045) and ACSC (OR: 0.90; p-value = 0.033) ED visits.

Conclusions: Disparities in ED visits between Black and White patients with asthma decrease when these patients receive care in care clinics with favorable NP work environments.

Keywords: emergency department; nurse practitioner; older adults; primary care; work environment.

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Conflict of interest statement

Competing Interests The authors declare no competing interests.

Figures

Figure 1
Figure 1
Odds of All-Cause and ACSC ED Visits among Medicare Patients with Asthma by Race and Standardized NP Work Environment Score (n=46,658) Abbreviations: NP = nurse practitioner, ACSC = ambulatory care sensitive condition, ED = emergency department, OR = odds ratio
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