Publications

Demand for health care professionals with expertise in long-term care (LTC) and older populations is rising, due to projected growth in the older population and the increasing burden of chronic disease. One way to meet this growing LTC workforce demand may be to employ more nurse practitioners (NPs) and/or physician assistants (PAs). Studies have demonstrated the value of NPs and PAs in the care of older people, including when they are substituted for physicians. This study is intended to inform educators, employers, and policymakers about employer demand for PAs and NPs in the care of older and disabled populations and to guide federal investments in workforce development and planning for these high-growth populations.

Methods

In this descriptive, cross-sectional study, we analyze job posting data for 2014 from a leading labor analytics firm and compare job postings in LTC and for care of elders and people with disabilities with occupied positions and with the overall job market for NPs and PAs.

Findings

• In 2014, 1 in 10 job openings for NPs and PAs were focused on care for older persons and/or people with disabilities
• Half of the jobs for this population required ≥1 year of experience, limiting the opportunities available to new graduates
• NPs are in higher demand than PAs for jobs caring for older people and people with disabilities • More than half of jobs focused on care of older and disabled populations are in primary care specialties
• The employment market for positions in LTC and care for older and disabled populations appears to be expanding for both NPs and PAs
• Twice as many NPs as physicians are employed in settings focused on older and disabled populations
• Employer demand for NPs and PAs in LTC and care for older persons/people with disabilities is low relative to specialty care

Conclusion

While job opportunities abound for NPs to care for older persons and those with disabilities, we have identified the lack of job availability for PAs as a potential barrier to entry. Employers may not fully understand PA education and how PAs are prepared to fill employment gaps for geriatric and disabled populations. NPs often have specific course content in gerontology and geriatrics, and most NPs focus on ambulatory care during their education. PAs also have education in these areas, as well as in surgery and other hospital-based and specialty fields. Employer demand for both NPs and PAs in specialty care is considerably higher than for primary care, and market forces alone are not likely to reverse this trend.