Racial and Ethnic Disparities in ED Use Among Older Adults with Asthma and Primary Care Nurse Practitioner Work Environments

Overview

Journal Res Sq

Date 2024 Apr 1

PMID 38559202

Authors

Lusine Poghosyan

Jianfang Liu

Eleanor Turi

Kathleen Flandrick

Marcia Robinson

Maureen George

Grant Martsolf

J Margo Brooks Carthon

Monica OReilly-Jacob

Affiliations

Soon will be listed here.

Abstract

Background: Nurse practitioners (NPs) increasingly deliver primary care in the United States. Yet, poor working conditions strain NP care. We examined whether racial/ethnic health disparities in ED visits among older adults with asthma are moderated by primary care NP work environments.

Methods: Survey data on NP work environments in six states were collected from 1,244 NPs in 2018-2019. 2018 Medicare claims data from 46,658 patients with asthma was merged with survey data to assess the associations of all-cause and ambulatory care sensitive conditions (ACSC) ED visits with NP work environment and race/ethnicity using logistic regression.

Results: NP work environment moderated the association of race (Black patients versus White patients) with all-cause (odds ratio [OR]: 0.91; p-value = 0.045) and ACSC (OR: 0.90; p-value = 0.033) ED visits.

Conclusions: Disparities in ED visits between Black and White patients with asthma decrease when these patients receive care in care clinics with favorable NP work environments.

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