A study published on August 15, 2025 on JAMA Network Open entitled “Clinician Volume and Outcomes Among Patients Admitted to Nursing Homes for Postacute Care” found that nursing home physician or advanced practitioner panel size was not associated with higher rates of rehospitalization, lower rates of successful discharge to community, or lower rates of functional improvement at discharge from postacute care in the nursing home, suggesting that nursing home physician and advanced practitioner panel size does not play a significant role in postacute care outcomes.
“[W]e did not find an association between clinician panel size and nursing home postacute care outcomes. These findings may inform the design of care models for clinicians practicing in nursing homes.”
Patient volume was measured by counting the number of unique patients seen by each clinician and categorized into deciles. The patient-weighted median (IQR) clinician patient volume (ie, the volume of the clinician seen by the median patient in the dataset) was 68 patients per year (31 to 128 patients). Four risk-adjusted outcomes of care—30-day rehospitalization, emergency department (ED) visit, successful discharge to community, and improvement in functional status at discharge—were measured using Medicare’s quality measures specifications.
The researchers reported that patients of clinicians in the lowest decile of patient volume did not experience significantly different outcomes compared with those in the highest decile: the incidence rate ratio (IRR) was 1.05 (95% CI, 0.76-1.46) for rehospitalizations, 0.96 (95% CI, 0.86-1.07) for successful discharge to community, 1.03 (95% CI, 0.90-1.19) for ED visits, and 0.96 (95% CI, 0.88-1.40) for functional improvement at discharge from the nursing home.
The study concluded: “Postacute care patients of clinicians who saw fewer nursing home patients did not experience meaningfully different outcomes compared with the patients of higher-volume clinicians. Moreover, more than half of nursing home clinicians saw fewer than 10 patients a year. Our findings suggest that efforts to improve outcomes of patients in postacute care in nursing homes are better directed elsewhere. The lack of an association between volume at the clinician level and patient outcomes may be a welcome finding considering that intervention targeting clinician volume such as minimum patient thresholds are not feasible in the nursing home setting.”
“Future research should also evaluate other aspects of physician and advanced practitioner practice in the nursing home such as increased on-site presence of higher-volume clinicians, specific training or expertise, commitment to nursing home practice, or relationships with nursing home direct care staff. These may include the medical staff organizational models employed and the degree of collaboration between advanced practitioners and physicians in the nursing home.”
If you or a loved one suffered harm while a resident of a nursing home in the United States due to nursing home pressure ulcers, nursing home understaffing, nursing home abuse, nursing home neglect, nursing home negligence, or the failure to provide appropriate care for a vulnerable adult, you should promptly find a nursing home claim lawyer in your state who may investigate your nursing home claim for you and file a nursing home claim on your behalf or behalf of your loved one, if appropriate.
Visit our website to be connected with medical malpractice attorneys (nursing home negligence attorneys) in your U.S. state who may assist you with your nursing home claim, or call us toll-free in the United States at 800-295-3959.
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