Residents receiving long-term care in nursing homes are medically complex. Half of these residents require assistance with at least four activities of daily life while also often dealing with dementia or hypertension. As such, primary care physicians and advanced practitioners play an integral role in these individuals’ lives, whether they deliver essential clinical services, develop care plans, or communicate with residents’ families.
Though these clinicians provide vital care, data on their characteristics is limited. To fill this gap, Dr. Hye-Young Jung, associate professor of population health sciences, and colleagues conducted a study published in The Journal of the Post-Acute and Long-Term Care Medical Association, which examines practice trends and characteristics of primary care physicians of nursing home residents from 2012 to 2019.
Researchers examined Medicare Fee-for-Service claims from a nationally representative sample of beneficiaries during this period. Data sources include the Physician and Other Supplier Public Use File, Medicare Data on Provider Practice and Specialty, and the Medicare ACO Provider file, among others.
Results indicate that most physicians providing primary care in US nursing homes were internal medicine specialists and family practitioners. Fewer geriatricians and physical medicine and rehabilitation physicians provide care in nursing homes, but they had the highest percentage of their services provided to nursing home residents. They also focused on residents with more complex care needs, but geriatricians are more concentrated in higher-quality nursing homes with more resources.
“Our findings suggest that creating a more supportive workplace environment could make nursing homes more attractive to geriatricians and other primary care physicians, ultimately enhancing care quality,” explained Dr. Jung. “Additionally, aligning workplace resources and staffing levels with the specific needs of these specialists could improve physician satisfaction and encourage more geriatricians to practice in nursing homes.”
Further research should assess the sources of variations observed, as these findings suggest potential disparities in access to primary care among residents and may reflect systemic problems in nursing home care.
- Highlights