The overall quality of heart disease and stroke outpatient care at primary care practices was comparable between physicians and non-physicians, such as nurse practitioners and physician assistants, according to research that was published Wednesday on the American Heart Association journal website Circulation: Cardiovascular Quality & Outcomes.
The research was originally scheduled to be released as part of the Quality of Care and Outcomes Research 2015 Scientific Sessions, which was cancelled due to violent protests in the city of Baltimore.
While studies have shown the quality of care provided by physicians and non-physicians in cardiology practices is comparable, this study compared cardiovascular care quality between physicians and non-physicians in the primary care setting.
Researchers identified 1,187,035 cardiovascular disease patients among those visiting 130 U.S. Department of Veteran Affairs facilities between October 2013 and September 2014. They reviewed specific quality indicators for cardiovascular care. They found that while the overall quality of care was comparable among providers, there were notable nuances:
- Patients under the care of non-physicians were more likely to have good control of their blood pressure.
- Patients seeing physicians were more likely to have control of their cholesterol and to be prescribed a beta blocker.
- Only 54 percent of patients seeing physicians and 54.8 percent seeing non-physicians met all three quality performance measures of achieving blood pressure control, receiving a statin and receiving a beta blocker.
Projections show there may not be enough physicians to care for the expected influx of patients from the Affordable Care Act. Nurse practitioners and physician assistants might help to fill the gap by providing chronic disease care.
Regardless of the provider type, there is a need to improve global primary care performance on measures of cardiovascular care quality, researchers said.