Journal article
Advanced practice providers and children’s hospital-based pediatric otolarynology practices
International journal of pediatric otorhinolaryngology, Vol.129, pp.109770-109770
02/2020
DOI: 10.1016/j.ijporl.2019.109770
PMID: 31733596
Abstract
Advanced practice providers (APPs), including nurse practitioners and physician assistants, have been deployed in children's hospital-based academic pediatric otolaryngology practices for many years. However, this relationship in terms of prevalence, roles, financial consequences and satisfaction has not been examined. The objective of this study is to explore how APPs impact healthcare delivery in this setting.
Pediatric otolaryngology chiefs of all academic children's hospitals in the US were electronically surveyed about the ways APPs intersected clinically and financially in their respective practice.
A total of 29 of 36 children's hospital-based pediatric otolaryngology practices completed the survey, of which 26 practices (90%) utilized APP. There were large variances within the APP practice cohort in faculty size (mean/median/range = 9.4/8.5/3–29); annual patient visits (mean/median = 18,373/17,600); number of practice site (mean/median/range = 4.3/4/2–9) and number of outpatient APP (mean/median/range = 6.3/5/1–30). No factors (faculty size, annual visits and number of practice sites) differentiated between the APP and non-APP practices. Among APP practices, significant correlation (p<.00001) was observed between size of APP cohort to faculty size and annual visits. 69% of the practices did not differentiate job functions of nurse practitioners and physician assistants. 85% of the practices utilized APPs in all practice sites and 19% utilized APPs in the operating room. 77% of APPs billed independently and 46% had on-site supervision. The most prevalent APP salary bracket based on 0–5, 6–10 and > 11 years of tenure were $76–100K (65%), $100–150K (77%) and $100–150K (86%), respectively. In 46% of the practices, APPs were able to generate enough revenue to cover more than 75% of their salary and 23% of practices generated a profit. 81% of the chiefs ranked the effectiveness of APPs as high (4 and 5) on a 5-point Likert scale.
The majority of academic pediatric otolaryngology practices employed APPs. Despite the diversity seen in practice complexity, APP functionality and financial impact, most found the APP model to be beneficial in improving patient care, patient access and faculty productivity.
Details
- Title: Subtitle
- Advanced practice providers and children’s hospital-based pediatric otolarynology practices
- Creators
- Kenny H Chan - Boston Children's HospitalJordyn K Dinwiddie - University of Colorado DenverGurpreet S Ahuja - University of California, IrvineErica C Bennett - University of New MexicoMatthew T Brigger - Naval Medical Center San DiegoDavid H Chi - University of PittsburghDaniel I Choo - Cincinnati Children's Hospital Medical CenterMichael J Cunningham - Boston Children's HospitalRavindhra G Elluru - Boston Children's HospitalCarla M Giannoni - Baylor College of MedicineSteven L Goudy - Emory UniversityJeffrey A Koempel - University of Southern CaliforniaCarol J MacArthur - Oregon Health & Science UniversityBarbara Malone - Children's Minnesota, St. Paul, MN, USA.Anna H Messner - Lucile Packard Children's HospitalRon B Mitchell - The University of Texas Southwestern Medical CenterAlbert H Park - Primary Children's HospitalGresham T Richter - University of Arkansas for Medical SciencesKristina W Rosbe - University of California, San FranciscoUdayan K Shah - Alfred I. duPont Hospital for ChildrenKathy C.Y Sie - University of WashingtonRichard J Smith - University of IowaCecille G Sulman - Children's Hospital of WisconsinJerome W Thompson - University of Tennessee Health Science CenterMarc C Thorne - Boston Children's HospitalJulie L Wei - University of Central FloridaRalph F Wetmore - University of PennsylvaniaDavid R White - Medical University of South CarolinaGeorge H Zalzal - Drexel UniversityScott R Schoem - University of Connecticut
- Resource Type
- Journal article
- Publication Details
- International journal of pediatric otorhinolaryngology, Vol.129, pp.109770-109770
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.ijporl.2019.109770
- PMID
- 31733596
- ISSN
- 0165-5876
- eISSN
- 1872-8464
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Otolaryngology; Internal Medicine
- Record Identifier
- 9984256929902771
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