Nebraska Comprehensive Community Health Care System Report: Assessment of Nebraska Primary Care Providers About Chronic Disease Management and Community-Clinical Linkages

Abstract

Abstract: This report summarizes a study of the demographics and scope of clinical services rendered by primary care providers to patients with chronic disease conditions residing in the state of Nebraska. This study specifically explored the disease management and community-clinical linkage strategies employed by primary care providers among patients with the chronic conditions of diabetes, hypertension, and obesity. To complete this work, we first developed a comprehensive database identifying the primary care providers within in their primary employment sites, and further identify those sites as either independent (unaffiliated with an organized health system) or grouped within an identifiable organized health system. A state-wide survey of providers was conducted via U.S. mail with 3 cycles of mailing completed. Our total number of primary care providers with independent practice authority who care for Nebraskans is estimated at 906, with 645 of these being physicians and 261 of these being nurse practitioners. A sixty percent response rate from primary care providers was achieved overall (n = 539 of 906) with a 59% response rate from physicians (n = 383 of 645) and a 60% response rate from nurse practitioners (n = 156 of 261). Findings describe chronic disease condition management strategies and the availability of supportive care programs to patients at local practices and through larger health system infrastructure. Findings are reported at the individual provider level, practice level and health system level. Our survey yielded a representation of 87 health systems from primary practice sites out of a possible approximate 97 health systems identifiable across the state. These findings provide an understanding of the current service provision, and the accessibility to patients of the services needed to reliably conduct chronic disease condition management through providers in the state of Nebraska.