NPs, PAs use more diagnostic imaging compared to physicians

(HealthDay)—Advanced practice clinicians (APCs) use more imaging than primary care physicians (PCPs), according to a study published online Nov. 24 in JAMA Internal Medicine.

Danny R. Hughes, Ph.D., from the Harvey L. Neiman Health Policy Institute in Reston, Va., and colleagues compared the use of diagnostic imaging ordered by APCs (specifically, nurse practitioners and physician assistants) versus PCPs following office-based encounters. Data were obtained from 2010 to 2011 Medicare claims for a 5 percent sample of beneficiaries.

The researchers found that APCs ordered imaging in 2.8 percent of episodes of care, compared with 1.9 percent for PCPs. APCs were more likely to order imaging than PCPs in adjusted estimates and across all patient groups and imaging services (odds ratio, 1.34), ordering 0.3 percent more images per episode. Increased radiography orders were seen for APCs on both new and established patients (odds ratios, 1.36 and 1.33, respectively), ordering 0.3 and 0.2 percent more images per episode of care, respectively. For advanced imaging, increased imaging was seen in association with APCs for established patients (odds ratio, 1.28), ordering 0.1 percent more images, while for new patients there was no significant difference between APCs and PCPs.

"While increased use of imaging appears modest for individual patients, this increase may have ramifications on care and overall costs at the population level," the authors write.

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