Medical Care Delivery in U.S. Nursing Homes: Current and Future Practice

Author:

Katz Paul R1,Ryskina Kira2,Saliba Debra3,Costa Andrew4,Jung Hye-Young5,Wagner Laura M6ORCID,Unruh Mark Aaron5,Smith Benjamin J7,Moser Andrea8,Spetz Joanne6ORCID,Feldman Sid8,Karuza Jurgis9

Affiliation:

1. Department of Geriatrics, Florida State University College of Medicine, Tallahassee

2. Department of Medicine, University of Pennsylvania, Philadelphia

3. Rand Corporation, Santa Monica, California

4. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

5. Population Health Sciences, Weill Cornell Medical College, New York City, New York

6. Healthforce Center, University of California San Francisco

7. School of Physician Assistant Practice, Florida State University, Tallahassee

8. Department of Family and Community Medicine, University of Toronto, Ontario, Canada

9. Department of Medicine, University of Rochester, New York

Abstract

Abstract The delivery of medical care services in U.S. nursing homes (NHs) is dependent on a workforce that comprises physicians, nurse practitioners, and physician assistants. Each of these disciplines operates under a unique regulatory framework while adhering to common standards of care. NH provider characteristics and their roles in NH care can illuminate potential links to clinical outcomes and overall quality of care with important policy and cost implications. This perspective provides an overview of what is currently known about medical provider practice in NH and organizational models of practice. Links to quality, both conceptual and established, are presented as is a research and policy agenda that addresses the gaps in the evidence base within the context of our ever-changing health care landscape.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Gerontology,General Medicine

Reference64 articles.

1. A clinical trial of nurse practitioner care in residential aged care facilities;Arendts;Archives of Gerontology and Geriatrics,2018

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