Meeting Abstract

JL532. The Quantity of Care Provided by Nurse Practitioners and Physician Assistants to Older Adults With Cancer

Lorinda A. Coombs, PhD(c), FNP-BC, AOCNP®, University of California San Francisco/Kaiser Permanente, San Francisco, California; Wendy Max, PhD, University of California San Francisco, San Francisco, California; Caroline Stephens, PhD, RN, GNP, University of California San Francisco, San Francisco, California, and Tatjana Kolevska, MD, University of California San Francisco/Kaiser Permanente, San Francisco, California

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Abstracts From 
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017

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Purposes/Aims: The purpose of this study was to: (1) Describe the number of nurse practitioners (NPs) and physician assistants providing care to older adults with cancer and the amount of care provided in 2013 and (2) Identify and describe the specific types of malignancies for which NPs and PAs provide greater amounts of care.

Background: The leading cause of death for individuals age 40 to 79 years in the United States is cancer. Approximately 40% of all Americans will be diagnosed with a malignancy in their lifetime. Cancer is most frequently diagnosed in adults over 65 years of age, and the incidence is expected to dramatically increase between 2010 and 2050. Estimates of the oncology workforce suggest there may not be enough oncology physicians in practice to care for these older patients with cancer. The lack of a sufficient cancer workforce will directly impact patient care and represents a public health issue.

Methods: Utilizing 2013 data from the Surveillance, Epidemiology and End Result (SEER) program linked to Medicare enrollment and provider data, provide a description of the oncology workforce who provides care to Medicare patients with cancer. All members of the oncology workforce who provide cancer care to patients with Medicare are in the dataset, including NPs, PAs, and physician specialists. Patient malignancy was identified using the using the associated International Classification of Diseases (ICD) code. Analysis included calculation of proportions, percentiles within and among the provider groups to identify if there was a significant amount of care provided by NPs and PAs.

Results: A significant amount of ambulatory cancer care was provided by NPs and PAs, 6.9% of the workforce was NPs and PAs, compared with medical oncologists, hematologists or double boarded hematology/oncology physicians who comprised 9.5% of the workforce.

Implications: This is the first study to present non-self-reported data on cancer care provided by NPs and PAs to any population. The public health implications of this study include: identifying a solution to the growing need for cancer care and the anticipated cancer workforce deficit, possibly reducing Medicare workforce expenditures for cancer care by fully utilizing the current workforce, and allowing specialty physicians to focus on complex care while nurse practitioners provide care within their scope of practice. Partial research support provided by Alpha Eta Chapter UCSF Sigma Theta Tau International Honor Society of Nursing, Earle Anthony Social Sciences Fellowship and the American Academy of Nurse Practitioners.

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