To meet the growing shortage of primary care physicians, many health systems are looking at alternate models of care by expanding the workforce of advance practice providers, or APPs, which include nurse practitioners and physician assistants.

A study by University of Texas Medical Branch was the first to examine the quality of COPD primary care delivered by physicians versus APPs on a national level. For the study, records of 7,257 Medicare COPD patients who had at least one hospitalization in 2010 were reviewed.

“We found that APPs were more likely to prescribe short-acting inhalers or oxygen therapy and to consult with a pulmonary specialist, but less likely to give flu and pneumonia vaccinations compared to physicians,” said Amitesh Agarwal, MD, lead author and fellow in the UTMB division of pulmonary critical care & sleep medicine. “Patients receiving care from APPs had lower rates of ER visits for COPD and a higher follow-up rate with a pulmonologist within 30 days of hospitalization for COPD than those cared for by a physician.”