Physician Practice Patterns in Nursing Homes

  • Cari Levy
    Correspondence
    Address correspondence to Cari Levy, MD, University of Colorado at Denver Health Sciences Center, 13611 E Colfax Ave, Suite 100, Aurora, CO 80045 and the Denver VA Medical Center, 4595 Hale Parkway, Suite 217, Denver, CO 80220.
    Affiliations
    Division of Healthcare Policy and Research, University of Colorado at Denver Health Sciences Center, Aurora, CO

    Denver Veterans Affairs Medical Center, Aurora, CO
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  • Sing-I.T. Palat
    Affiliations
    Division of Geriatric Medicine, University of Colorado at Denver Health Sciences Center, Denver, CO.
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  • Andrew M. Kramer
    Affiliations
    Division of Healthcare Policy and Research, University of Colorado at Denver Health Sciences Center, Aurora, CO
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      This review of the literature describes models of physician practice in nursing homes including the barriers to increasing physician workforce in nursing homes and the impact of various physician practice models on quality of care in nursing homes. Traditional nursing home practice is first described followed by a review of the literature pertaining to nurse practitioners and physician assistants in nursing home practices, closed staffing models, managed care, and nursing home specialist models. Literature describing barriers to increasing the physician workforce in nursing homes is then presented including training, reimbursement, and malpractice insurance for physicians who work in nursing homes. Finally, the impact of physician practice models on quality of care is reviewed with a focus on frequency of visits, hospitalizations, cost-effectiveness, communication, and patient satisfaction.

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