Nadeen N Faza1, Julia M Akeroyd, David J Ramsey, Tina Shah, Khurram Nasir, Anita Deswal, Christie M Ballantyne, Laura A Petersen, Salim S Virani. 1. Nadeen N. Faza is a cardiovascular disease fellow at Baylor College of Medicine in Houston, Tex. Julia M. Akeroyd is a project manager at Baylor College of Medicine. David J. Ramsey is a senior biostatistician at the Michael E. DeBakey VA Medical Center in Houston. Tina Shah is a staff cardiologist at the DeBakey VA Medical Center and an assistant professor at Baylor College of Medicine. Khurram Nasir is director of the Center for Healthcare Advancement and Outcomes and director of the High Risk Cardiovascular Disease Clinic at Baptist Health South Florida in Miami, Fla.; an adjunct professor of medicine and epidemiology at Florida International University in Miami; and an adjunct assistant professor at Johns Hopkins University's Ciccarone Center for Preventive Cardiology in Baltimore, Md. Anita Deswal is chief of cardiology at the DeBakey VA Medical Center in Houston, Tex., and a professor of medicine at Baylor College of Medicine. Christie M. Ballantyne is director of the Center for Cardiovascular Disease Prevention at Methodist DeBakey Heart Center. At Baylor College of Medicine, she is chief of the Section of Cardiovascular Research, J.S. Abercrombie Chair in Atherosclerosis and Lipoprotein Research, chief of the Section of Cardiology in the Department of Medicine, director of the Maria and Alando J. Ballantyne, MD, Atherosclerosis Laboratory, and a professor of medicine, professor of genetics, professor of physiology with a joint appointment in pediatrics. She also is director of the Lipid Metabolism and Atherosclerosis Clinic at Methodist Hospital in Houston, Tex. Laura A. Petersen is director of the Center for Innovations in Quality, Effectiveness, and Safety and associate chief of staff for research at the DeBakey VA Medical Center and a professor of medicine and chief of the Section of Health Services Research at Baylor College of Medicine. Salim S. Virani is a staff cardiologist at the DeBakey VA Medical Center and an associate professor of medicine and associate director for research in the center's cardiology fellowship training program. The authors have disclosed that this research was supported by grants from the American Heart Association Beginning Grant-in-Aid, American Diabetes Association Clinical Science and Epidemiology Award, and DeBakey VA Medical Center's Health Services Resource and Development Center for Innovations. The authors have disclosed no other potential conflicts of interest, financial or otherwise. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs, the US government, or Baylor College of Medicine.
Abstract
BACKGROUND: The effectiveness of cardiovascular disease (CVD) and diabetes care delivered by NPs and physician assistants (PAs), and resource use by these providers has not been studied. METHODS: We performed regression analyses of patients with diabetes or CVD with a primary care visit in 130 Veterans Affairs (VA) facilities to assess the association between provider type and effectiveness or resource use. RESULTS: The diabetes cohort consisted of 156,034 patients assigned to NPs and 54,590 assigned to PAs. Glycemic and BP control, statin use, number of primary or specialty care visits, lipid panels, and A1C results were comparable between groups. The CVD cohort consisted of 185,694 patients assigned to NPs and 66,217 assigned to PAs. BP control; use of beta-blockers, statins, or antiplatelets; primary or specialty care visits; lipid panels; and number of stress tests ordered were comparable between groups. CONCLUSION: Effectiveness of care and resource use among patients in both groups were comparable.
BACKGROUND: The effectiveness of cardiovascular disease (CVD) and diabetes care delivered by NPs and physician assistants (PAs), and resource use by these providers has not been studied. METHODS: We performed regression analyses of patients with diabetes or CVD with a primary care visit in 130 Veterans Affairs (VA) facilities to assess the association between provider type and effectiveness or resource use. RESULTS: The diabetes cohort consisted of 156,034 patients assigned to NPs and 54,590 assigned to PAs. Glycemic and BP control, statin use, number of primary or specialty care visits, lipid panels, and A1C results were comparable between groups. The CVD cohort consisted of 185,694 patients assigned to NPs and 66,217 assigned to PAs. BP control; use of beta-blockers, statins, or antiplatelets; primary or specialty care visits; lipid panels; and number of stress tests ordered were comparable between groups. CONCLUSION: Effectiveness of care and resource use among patients in both groups were comparable.