Differences in the delivery of health education to patients with chronic disease by provider type, 2005-2009

Tamara S. Ritsema, Jeffrey B. Bingenheimer, Patty Scholting, James F. Cawley

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Introduction: Health education provided to patients can reduce mortality and morbidity of chronic disease. Although some studies describe the provision of health education by physicians, few studies have examined how physicians, physician assistants, and nurse practitioners differ in the provision of health education. The objective of our study was to evaluate the rate of health education provision by physicians, physician assistants, and nurse practitioners/certified midwives. Methods: We analyzed 5 years of data (2005-2009) from the outpatient department subset of the National Hospital Ambulatory Medical Care Survey. We abstracted data on 136,432 adult patient visits for the following chronic conditions: asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, and obesity. Results: Health education was not routinely provided to patients who had a chronic condition. The percentage of patients who received education on their chronic condition ranged from 13.0% (patients with COPD or asthma who were provided education on smoking cessation by nurse practitioners) to 42.2% (patients with diabetes or obesity who were provided education on exercise by physician assistants). For all conditions assessed, rates of health education were higher among physician assistants and nurse practitioners than among physicians. Conclusion: Physician assistants and nurse practitioners provided health education to patients with chronic illness more regularly than did physicians, although none of the 3 types of clinicians routinely provided health education. Possible explanations include training differences, differing roles within a clinic by provider type, or increased clinical demands on physicians. More research is needed to understand the causes of these differences and potential opportunities to increase the delivery of condition-specific education to patients.

Original languageEnglish (US)
Article number130175
JournalPreventing Chronic Disease
Volume11
Issue number3
DOIs
StatePublished - Mar 2014

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Patient Education
Health Education
Physician Assistants
Chronic Disease
Nurse Practitioners
Physicians
Education
Chronic Obstructive Pulmonary Disease
Asthma
Obesity
Health Care Surveys
Midwifery
Smoking Cessation
Hyperlipidemias
Myocardial Ischemia
Outpatients
Exercise
Depression
Hypertension
Morbidity

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Differences in the delivery of health education to patients with chronic disease by provider type, 2005-2009. / Ritsema, Tamara S.; Bingenheimer, Jeffrey B.; Scholting, Patty; Cawley, James F.

In: Preventing Chronic Disease, Vol. 11, No. 3, 130175, 03.2014.

Research output: Contribution to journalArticle

Ritsema, Tamara S. ; Bingenheimer, Jeffrey B. ; Scholting, Patty ; Cawley, James F. / Differences in the delivery of health education to patients with chronic disease by provider type, 2005-2009. In: Preventing Chronic Disease. 2014 ; Vol. 11, No. 3.
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abstract = "Introduction: Health education provided to patients can reduce mortality and morbidity of chronic disease. Although some studies describe the provision of health education by physicians, few studies have examined how physicians, physician assistants, and nurse practitioners differ in the provision of health education. The objective of our study was to evaluate the rate of health education provision by physicians, physician assistants, and nurse practitioners/certified midwives. Methods: We analyzed 5 years of data (2005-2009) from the outpatient department subset of the National Hospital Ambulatory Medical Care Survey. We abstracted data on 136,432 adult patient visits for the following chronic conditions: asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, and obesity. Results: Health education was not routinely provided to patients who had a chronic condition. The percentage of patients who received education on their chronic condition ranged from 13.0{\%} (patients with COPD or asthma who were provided education on smoking cessation by nurse practitioners) to 42.2{\%} (patients with diabetes or obesity who were provided education on exercise by physician assistants). For all conditions assessed, rates of health education were higher among physician assistants and nurse practitioners than among physicians. Conclusion: Physician assistants and nurse practitioners provided health education to patients with chronic illness more regularly than did physicians, although none of the 3 types of clinicians routinely provided health education. Possible explanations include training differences, differing roles within a clinic by provider type, or increased clinical demands on physicians. More research is needed to understand the causes of these differences and potential opportunities to increase the delivery of condition-specific education to patients.",
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