Study Finds Geriatric Physician & NP Workforce Kept Pace with Aging Population, But Significant Rural Disparities Persist

A new study published in JAMA Network Open finds that geriatric nurse practitioners (NPs) helped expand the geriatric workforce and kept the combined geriatric physician and NP workforce on pace with the growth of the older population. It also exposes significant geographic disparities in geriatric healthcare, highlighting that nearly two-thirds of U.S. counties lack specialized geriatric healthcare professionals.

The study analyzed geriatric healthcare workforce trends from 2010 to 2020 when the older population experienced the fastest growth since 1880-1890, led by Ying Xue, DNSc, RN, the Loretta C. Ford Endowed Professor in Primary Care Nursing at the University of Rochester School of Nursing. While the national geriatric workforce grew and maintained proportional representation, the distribution remained highly uneven.

"Instead of devoting more resources to increasing the total number of geriatric professionals, great attention should be focused on addressing the geographic disparities in access to geriatric care," said Xue. "Policymakers should recognize this so that efforts and resources could be allocated accordingly."

Most notably, the study found that counties without geriatric professionals typically:

• Have smaller older adult populations
• Demonstrate lower socioeconomic status
• Possess fewer healthcare resources and facilities

The dramatic increase in geriatric nurse practitioners emerged as a critical strategy for addressing healthcare access challenges, particularly in underserved areas.

With the older adult population projected to grow by 25 million from 2020 to 2040, the research underscores the urgent need for strategic workforce development to ensure comprehensive older adult care.

"To address geographic disparities in geriatric care access, we must implement targeted policies that both incentivize healthcare professionals to serve rural communities and support the financial sustainability of healthcare facilities in these underserved areas," said Xue. 

Co-authors on the study include Lusine Poghosyan, PhD, MPH, RN, with Columbia University’s School of Nursing and Qinyun Lin, PhD, with the University of Gothenburg’s Institute of Medicine School of Public Health & Community.

The researchers analyzed data from 2010 to 2020 using two national data sets: the Area Health Resources File (AHRF) and the National Provider Identifier (NPI) registry. Xue received support for the study from the Drs. Jeremy A. Klainer and Pamela York Klainer Endowed Dean’s Discretionary Award in Nursing from the University of Rochester School of Nursing.

Read the full study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2826107