Patient Satisfaction with Physician Assistant, Nurse Practitioner, and Physician Care: A National Survey of Medicare Beneficiaries

Abstract

• Objective: To assess the extent to which the experiences of older patients vary according to type of primary care provider (ie, physician assistant [PA], nurse practitioner [NP], or physician). • Design: National, cross-sectional survey. • Participants: Medicare beneficiaries completing the 2000 and 2001 Medicare fee-for-service Consumer Assessment of Health Plans Survey who identified a primary care provider. • Measurements: Satisfaction data, patient sociodemographic characteristics, health care experience, types of care, types of insurance. • Results: 146,880 completed surveys from 321,407 randomly sampled Medicare beneficiaries nationwide (45.7% of total surveyed) were analyzed. 3770 respondents (2.8%) identified a PA or an NP as their personal provider. For questions on satisfaction with their personal care clinician, results were similar across the 3 providers. Patients who reported an NP as their primary care provider were significantly more likely to be Medicaid recipients as compared with patients who reported receiving care from a PA or physician. Patients who reported a physician as their primary care provider were more likely to have supplemental insurance as compared with patients who reported receiving care from a PA or NP. • Conclusion: Medicare beneficiaries are generally satisfied with their medical care and do not distinguish preferences based on type of provider. Nonphysician clinicians and physicians in primary care seemed to be viewed similarly regardless of patient characteristics. PAs and NPs may be a workforce that could be expanded to care for the rising needs of the elderly.