NPs, PAs order more diagnostic imaging compared to physicians, study finds

Advanced practice clinicians, including nurse practitioners and physician assistants, order more imaging for diagnostic testing following evaluation and management office visits, according to a recent study published in JAMA Internal Medicine.

Researchers used 2010-2011 Medicare claims for a 5 percent sample of beneficiaries to compare diagnostic imaging ordering between advanced practice clinicians and primary care physicians' episodes of care.

The study found that NPs and PAs ordered imaging in 2.8 percent of episodes of care, while PCPs ordered imaging 1.9 percent of the time. In adjusted estimates and across all patient groups and imaging services included in the study, NPs and PAs ordered 0.3 percent more images per episode.

Further findings indicate NPs and PAs were associated with increased radiography orders for both new and established patients, with 0.3 percent and 0.2 percent more orders for imaging per episode of care than PCPs, respectively.

NPs and PAs ordered 0.1 percent more images for advanced imaging on established patients than PCPs, but did not show significantly significant differences in ordering for new patients.

According to JAMA, while the expanding use of NPs and PAs may help alleviate PCP shortages, the increased ordering of diagnostic imaging may have significant ramifications on care and overall costs at the population level.

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