Primary Health Care in Community Health Centers and Comparison with Office-Based Practice
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We examine the roles of nurse practitioners (NPs), physician assistants (PAs), and nurse midwives (CNMs) in community health centers (CHCs). We also compare primary care physicians in CHCs with office-based physicians. Estimates are from the National Ambulatory Medical Care Survey, a nationally representative annual survey of nonfederal, office-based patient care physicians and their visits. Analysis of primary care delivery in CHCs and office-based practices are based on 1,434 providers and their visits (n = 32,300). During 2006–2007, on average, physicians comprised 70% of CHC clinicians, with NPs (20%), PAs (9%), and CNMs (1%) making up the remainder. PAs, NPs, and CNMs provided care in almost a third of CHC primary care visits; 87% of visits to these CHC providers were independent of physicians. Types of patients seen by clinicians suggest a division of labor in caring for CHC patients. NPs and PAs were more likely than physicians to report providing health education services. There were no other differences among services examined. Office-based physicians were less likely to work alongside PAs/NPs/CNMs than CHC physicians. CHC staffing is contingent on a variety of providers. CHC staffing patterns may serve as models of primary care staffing for office practices as demand for primary care services nationwide increases.
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About this Article
- Primary Health Care in Community Health Centers and Comparison with Office-Based Practice
Journal of Community Health
Volume 36, Issue 3 , pp 406-413
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Community health centers
- Physician assistants
- Nurse practitioners
- Nurse midwives
- Primary care
- Author Affiliations
- 1. National Center for Health Statistics, 3311 Toledo Road, Room 3409, Hyattsville, MD, 20782, USA
- 2. School of Public Health, University of North Texas Health Sciences Center, Fort Worth, TX, USA
- 3. Department of Veterans Affairs, Dallas VA Medical Center, 4500 S. Lancaster Rd (111), Dallas, TX, 75216-7191, USA