A study by New Haven, Conn.-based Yale University and Fair Haven Community Health Care is challenging the assumption that more physicians in clinics lead to better performance on health metrics.
The study, published Oct. 22 in JAMA Open Network, analyzed the staffing models of 791 health centers serving 16 million patients. Researchers looked at how well each staffing model performed against 14 measures that health centers are regularly evaluated on.
The staffing models fell into five categories: balanced proportion of physicians, nurse practitioners and physician assistants; more NPs than physicians; more physicians than NPs; roughly equal proportions of physicians and NPs; and large health centers with workforces two to five times larger than other centers.
Here are three key findings:
- Models with more physicians had higher rates of diagnostic-related measures, such as cancer screenings and HIV testing.
- Models with more NPs and PAs showed better performance on health promotion metrics, including obesity assessments, healthy eating counseling and infant vaccinations.
- Staffing model had no impact on seven of the 14 metrics analyzed.
"The findings challenge assumptions that it is always better to staff with more physicians and highlight how strategic hiring could allow health centers to tackle specific health challenges in their communities," an Oct. 22 Yale news release said.
Health centers provide care to about 31.5 million Americans annually, many of whom live in poverty or in medically underserved urban and rural communities.