Advanced Practice Providers and Western Providers Are Associated With Increased Likelihood of Benign Skin Biopsies: A Cross-sectional Analysis

Abstract

Background and objective: To identify provider-related characteristics associated with a higher proportion of benign skin biopsies.

Patients and materials/methods: Medicare Part B database was analyzed, and for each provider, the number of skin biopsies that he/she performed that were benign lesions was estimated.

Results: Increased benign skin biopsies were performed by nurse practitioners and physician assistants (as compared to Doctor of Medicine/Doctor of Osteopathic Medicine) (odds ratio [OR] of 1.9 and 1.6, respectively), providers in the Northeast (OR 1.2), West (OR 1.2), or Midwest (OR 1.1) (as compared to the South), providers in metropolitan cities (OR 1.1), and providers in states with a higher cost of living index. Multivariable regression analysis revealed provider credentials, city size, and the West region to be significant (p < .05) factors in the number needed to biopsy to detect 1 malignant lesion.

Conclusion: This analysis is performed only on Medicare patients, which can limit the generalizability of the results over all the population groups. Nurse practitioners and physician assistants (as compared to Doctor of Medicine/Doctor of Osteopathic Medicine), providers practicing in the West (as compared to in the South), and providers practicing in metropolitan cities (as compared to nonmetropolitan cities) were more likely to perform benign skin biopsies than their counterparts.