HealthDay News — From 2012 to 2015 there was a relative increase in the number of nursing home specialists, including an increasing number of generalist physicians billing for nursing home care, according to a research letter published in the Journal of the American Medical Association.

Kira L. Ryskina, MD, from the University of Pennsylvania Perelman School of Medicine, and colleagues used the Provider Utilization Files to identify generalist physicians and advanced practitioners who provided nursing home-based care from 2012 to 2015. Episodes of care were aggregated by clinician to measure the proportion of episodes that were nursing home-based. Clinicians who billed at least 90% of episodes from the nursing home were defined as nursing home specialists.

The researchers found that 15.7% of the 319,264 unique generalist clinicians billed for nursing home care from 2012 through 2015. The number of clinicians billing for nursing home care remained relatively stable (−0.4%), while there was an increase of 15.6% in the total number of generalists. There was a relative increase of 33.7% in the number of nursing home specialists (5,127 to 6,857; P for trend<.001). From 2012 to 2015 there was an increase in the number of nursing home specialists per 1,000 beds, from 3.35 to 4.58 (P for trend<.001).

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“Whether these changes improve outcomes (e.g., through increased access to expert clinicians) or result in adverse consequences (e.g., due to worsened care fragmentation) requires ongoing study,” the authors write.

One author disclosed financial ties to Pfizer.

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Ryskina KL, Polsky D, Werner RM. Physicians and advanced practitioners specializing in nursing home care, 2012-2015. JAMA. 2017;318(20):2040-2042.