Browsing by Subject "Health workforce"

Now showing 1 - 5 of 5
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    Exploring the Demographic and Professional Characteristics of Physicians and Nurse Practitioners Associated With Providing Medication-Assisted Treatment: A Retrospective Observational Study
    (Sage, 2024) Maxey, Hannah L.; Vaughn, Sierra X.; Dickinson, Analise; Newhouse, Robin; Medicine, School of Medicine
    Integration of medication-assisted treatment (MAT) for opioid use disorder in primary care settings is an emerging health care delivery model that supports increased access to specialized care but requires primary care provider engagement. Examining the characteristics of providers who provide this service is key to informing targeted recruitment. Using administrative and supplemental data collected during license renewal, this study aimed to identify the characteristics of primary care physicians and nurse practitioners (NPs) associated with greater odds of providing MAT in their practice. A retrospective observational study was conducted using a descriptive correlational design. The analysis included 5259 physicians and 3486 NPs who renewed their licenses electronically in 2021 and specialized in primary care or psychiatry. Chi-square and logistic regression analyses were conducted to identify the demographic and clinical characteristics of physicians and NPs associated with MAT participation in their practice. Physicians had a higher odds ratio (OR) of providing MAT if they were younger than 35 years (OR = 1.334; P = .0443), practiced in a federally qualified health center (OR = 3.101, P < .0001), and offered a sliding fee scale in their practice (OR = 2.046; P < .0001). Likewise, NPs had higher odds of providing MAT if they practiced in a public or community health center (OR = 3.866; P < .0001). The results of this study highlight the personal and professional characteristics of physicians and NPs associated with higher odds of providing MAT. These findings may have implications for the recruitment and sustainability of MAT integration in primary care.
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    Nurse practitioner patient care patterns and practice characteristics : understanding the role of state scope-of-practice policies
    (2017-05-09) Norwood, Connor W.; Harle, Christopher; Menachemi, Nir; Stone, Cynthia; Liu, Ziyue
    Introduction: The U.S. is faced with a primary care (PC) workforce shortage; an estimated 43 percent of the population has unmet health care needs and 18.2 percent of the adult population lacks a usual source of care (USC) provider. The workforce shortage limits even those with a USC from receiving the full scope of recommended clinical services. One promising solution is reforming scope-of-practice (SOP) policies for PC nurse practitioners (NPs). Objectives: The primary objective of this dissertation was to assess the impact of NP SOP policy implementation on NP practice patterns and patient access to PC by evaluating NP time spent delivering patient care, NP role as USC providers, patient travel times, and appointment availability. Methods: The studies discussed in this dissertation leveraged cross-sectional data from the National Sample Survey of Nurse Practitioners (NSSNP), time-series data from the Medical Expenditure Panel Survey (MEPS), and the Nurse Practitioner Professional Practice Index (NPPPI) to quantify variations in state policy environments. We used generalized mixed effects models to examine relationships in the cross-sectional data analyses and two-way fixed effect models to evaluate longitudinal data. Results: Our analyses revealed several key findings: NP SOP policies do impact the percentage of time NPs spend providing direct patient care; the NP workforce role as USC providers has increased as SOP policies have changed; states with supportive reimbursement policies have more NPs working as USC providers; and states with fewer NP supervision requirements have shorter patient travel times to USC providers. Conclusion: The U.S. health care system must continue to evolve to address the growing demand for PC services. While strategies to increase the supply of PC providers may be an effective long-term solution, our findings suggest that NP SOP reform may be a viable and complementary strategy to increasing the capacity of the PC workforce, providing more immediate relief.
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    A proposal for the addressing the needs of the pediatric pulmonary work force
    (Wiley, 2020-08) Gaston, Benjamin; Laguna, Theresa A.; Noah, Terry L.; Hagood, James; Voynow, Judith; Ferkol, Thomas; Hershenson, Marc; Boyne, Katie; Deleceris, Angela; Ross, Kristie; Gozal, David; Celedón, Juan C.; Abman, Steven H.; Moore, Paul; Davis, Stephanie; Cornfield, David N.; Murphy, Thomas; Pediatrics, School of Medicine
    Unprecedented opportunities and daunting difficulties are anticipated in the future of pediatric pulmonary medicine. To address these issues and optimize pediatric pulmonary training, a group of faculty from various institutions met in 2019 and proposed specific, long-term solutions to the emerging problems in the field. Input on these ideas was then solicited more broadly from faculty with relevant expertise and from recent trainees. This proposal is a synthesis of these ideas. Pediatric pulmonology was among the first pediatric specialties to be grounded deliberately in science, requiring its fellows to demonstrate expertise in scientific inquiry (1). In the future, we will need more training in science, not less. Specifically, the scope of scientific inquiry will need to be broader. The proposal outlined below is designed to help optimize the practices of current providers and to prepare the next generation to be leaders in pediatric care in the future. We are optimistic that this can be accomplished. Our broad objectives are (a) to meet the pediatric subspecialty workforce demand by increasing interest and participation in pediatric pulmonary training; (b) to modernize training to ensure that future pediatric pulmonologists will be prepared clinically and scientifically for the future of the field; (c) to train pediatric pulmonologists who will add value in the future of pediatric healthcare, complemented by advanced practice providers and artificial intelligence systems that are well-informed to optimize quality healthcare delivery; and (d) to decrease the cost and improve the quality of care provided to children with respiratory diseases.
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    Staying Put or Moving Out? Analyzing Post-Residency Decisions of Family Medicine Physicians in Indiana: A 12-Year Survey Study
    (2024-04-26) Ho, Monling; Potter, Maddie; Kochhar, Komal; Wallach, Paul
    Background: Understanding the factors influencing the practice location decisions of family medicine residents is critical for healthcare workforce planning. This is particularly pertinent given the persistent challenge of attracting medical school graduates to primary care and ensuring the distribution of primary care physicians to underserved areas. Study objective: This study aims to investigate the factors determining the practice choices of Indiana family medicine residents upon completing their residency, with the purpose of informing state initiatives to effectively recruit and retain physicians in areas of need. Methods: Since 2012, an annual cross-sectional survey has been administered to all final-year family medicine residents in Indiana (including both IUSM and non-IUSM programs), to gather information on their post-graduation plans and the reasons behind their practice location choices. Geographical Information Systems software was used to display the family medicine residents’ intended practice locations. The study has received exempt approval from the Indiana University Institutional Review Board and has analyzed data spanning twelve years. Results: The survey revealed a near-even gender split among respondents (55% male, 45% female), with 11% belonging to underrepresented groups in medicine. One-half reported Indiana as their hometown. 31% graduated from a medical school in Indiana, with 22% from IUSM and 9% from Marian University College of Osteopathic Medicine. The majority were MDs (63%), while 37% were DOs. One-half had educational debt exceeding $250,000. Most respondents felt “fully competent” in ACGME competency areas (91%), were trained to serve rural and underserved populations (86%), felt “fully competent” to serve rural and underserved populations (78%), and had the opportunity to participate in quality improvement/patient safety projects as well as to serve on committees during their training (91%). A majority “strongly agreed” or “agreed” that the quality of their program (87%), their faculty (83%), and their peers (88%) had exceeded expectations. Wellness was rated highly, with 76% indicating “excellent” or “very good” overall wellness, although 44% reported burnout. Most “strongly agreed” or “agreed” that their personal and professional lives were well-balanced (70%) and that they had resources available to maintain their wellness (81%). For practice location, 67% planned to stay in Indiana, 31% intended to leave the state, and 2% were undecided. Proximity to family (49%) and reasonable cost of practice in the state (49%) were the top reasons for choosing Indiana, while proximity to their family (50%) or their spouse’s family (43%) were cited as reasons to practice elsewhere. Conclusion: This study demonstrates the success of Indiana’s family medicine residency programs in maintaining a strong family physician workforce within the state over the past 12 years.
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    The Politicization of Public Health and the Impact on Health Officials and the Workforce: Charting a Path Forward
    (American Public Health Association, 2022) Yeager, Valerie A.; Health Policy and Management, School of Public Health