Older adults from racial and ethnic minoritized groups experience higher asthma prevalence, morbidity, and mortality, often relying on emergency departments (EDs) for asthma management. High-quality primary care, increasingly provided by nurse practitioners (NPs), can improve asthma outcomes, yet NPs frequently work in poor environments that strain care delivery. In this study, researchers examined whether the NP work environment influences racial and ethnic disparities in ED visits among older adults with asthma. Data were collected from 1,244 NPs across six states and merged with Medicare claims from 46,658 patients to assess associations between NP work environment, patient race and ethnicity, and ED use.
Findings revealed that over one-third of asthma patients visited the ED within a year, with Black and Hispanic patients experiencing higher ED use than White patients. Importantly, better NP work environments were linked to reduced disparities in ED visits between Black and White patients. Clinics with more favorable NP work environments showed lower odds of all-cause and ambulatory care-sensitive condition ED visits. These results suggest that improving NP work environments in primary care settings may help prevent unnecessary ED visits and narrow racial and ethnic health disparities among older adults with asthma.
Reference: Poghosyan L, Liu J, Turi E, et al. Racial and Ethnic Disparities in Emergency Department Use Among Older Adults With Asthma and Primary Care Nurse Practitioner Work Environments. Nurs Res. 2025 Jan-Feb 01;74(1):64-72. doi: 10.1097/NNR.0000000000000780. Epub 2024 Sep 27. PMID: 39330763; PMCID: PMC11637959.
