Frazier Karen, Paez Kathryn A, Creek Emily, Vinci Arlene, Amolegbe Andrew, Hasanbasri Arifah
American Institutes for Research, Arlington, Virginia.
Arthritis Foundation, Atlanta, Georgia.
Arthritis Care Res (Hoboken). 2022 Oct;74(10):1593-1601. doi: 10.1002/acr.24618. Epub 2022 Jun 29.
To assess whether patients with autoimmune disease would accept advanced practice providers (APPs) as an option to fill the growing shortage of rheumatologists.
We administered a cross-sectional survey to 500 patients or parents of children who reported having been diagnosed with qualifying autoimmune conditions and who had seen their primary rheumatology providers in the past 6 months. Respondents self-reported whether their primary providers were rheumatologists or APPs. Our analysis compared the attitude and experience of the patients whose primary rheumatology providers were APPs with those of patients whose primary providers were rheumatologists.
Of respondents, 36.8% reported having APPs as primary rheumatology providers. Patients of APPs were significantly more likely to arrive at their provider's office in 15 minutes or less (P < 0.01) and to be able to schedule routine and urgent appointments sooner (P = 0.02 and 0.05, respectively). There were no significant differences in overall patient experience of care between provider types. Most patients rated their providers highly, but those who saw rheumatologists rated their providers significantly higher (P < 0.01). Patients of APPs were significantly more likely than patients of rheumatologists to prefer to see APPs over rheumatologists (P < 0.01) and to recommend APPs (P < 0.01).
APPs may improve access to care and, regardless of provider type, patients rated their overall experience of care similarly. Overall, patient attitudes toward APPs were positive regardless of provider type, although APP patients held more positive overall attitudes toward APPs than did rheumatologist patients.
评估自身免疫性疾病患者是否会接受高级执业医师（APPs）作为填补日益短缺的风湿病专家的一种选择。
我们对500名报告被诊断患有符合条件的自身免疫性疾病且在过去6个月内看过其主要风湿病专家的患者或儿童家长进行了横断面调查。受访者自行报告其主要医疗服务提供者是风湿病专家还是高级执业医师。我们的分析比较了主要风湿病专家为高级执业医师的患者与主要医疗服务提供者为风湿病专家的患者的态度和就医体验。
在受访者中，36.8%报告其主要风湿病专家为高级执业医师。高级执业医师的患者在15分钟或更短时间内到达医生办公室的可能性显著更高（P < 0.01），并且能够更快安排常规和紧急预约（分别为P = 0.02和0.05）。不同类型医疗服务提供者之间患者的总体就医体验没有显著差异。大多数患者对其医疗服务提供者评价很高，但看过风湿病专家的患者对其医疗服务提供者的评价显著更高（P < 0.01）。与看过风湿病专家的患者相比，高级执业医师的患者更有可能更愿意看高级执业医师而不是风湿病专家（P < 0.01），并推荐高级执业医师（P < 0.01）。
高级执业医师可能会改善就医机会，并且无论医疗服务提供者类型如何，患者对其总体就医体验的评价相似。总体而言，无论医疗服务提供者类型如何，患者对高级执业医师的态度都是积极的，尽管高级执业医师的患者对高级执业医师的总体态度比看过风湿病专家的患者更为积极。
