Physician substitution by mid-level providers in primary healthcare for the elderly: a protocol for a systematic review
Physician substitution by mid-level providers in primary healthcare for the elderly: a protocol for a systematic review
AIM: This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings.
BACKGROUND: Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking.
DESIGN: A quantitative systematic literature review using Cochrane methods.
METHODS: The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider: PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science. Study selection, data extraction and quality appraisal will be conducted independently by two reviewers. Data synthesis will consist of a qualitative analysis of the data. Funding of the review was confirmed in August 2013 by the Ministry of Health, Welfare and Sport of the Netherlands.
DISCUSSION: This review will contribute to the knowledge on effects of physician substitution in healthcare for older people and factors that influence the outcomes. This knowledge will guide professionals and policy administrators in their decisions to optimize healthcare for older people.
long-term care facilities, nurse practitioner, physician assistant, physician substitution, primary healthcare for older people, systematic review
Lovink, M.H.
d0376978-a938-4dfc-aa14-ceff6db3e566
Persoon, A.
de9c93d6-00ae-46e5-8adb-275e5db7cdf5
van Vught, A.J.A.H.
0967622b-70e8-4e9e-93e7-b7a3ba2a6050
Koopmans, R.T.C.M.
3a737cec-3104-44d4-8852-a239b2f7c08a
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Laurant, M.G.H.
23b610b8-03fe-49d3-b853-5be2f999b5e9
Lovink, M.H.
d0376978-a938-4dfc-aa14-ceff6db3e566
Persoon, A.
de9c93d6-00ae-46e5-8adb-275e5db7cdf5
van Vught, A.J.A.H.
0967622b-70e8-4e9e-93e7-b7a3ba2a6050
Koopmans, R.T.C.M.
3a737cec-3104-44d4-8852-a239b2f7c08a
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Laurant, M.G.H.
23b610b8-03fe-49d3-b853-5be2f999b5e9
Lovink, M.H., Persoon, A., van Vught, A.J.A.H., Koopmans, R.T.C.M., Schoonhoven, Lisette and Laurant, M.G.H.
(2015)
Physician substitution by mid-level providers in primary healthcare for the elderly: a protocol for a systematic review.
Journal of Advanced Nursing.
(doi:10.1111/jan.12759).
(PMID:26383740)
Abstract
AIM: This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings.
BACKGROUND: Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking.
DESIGN: A quantitative systematic literature review using Cochrane methods.
METHODS: The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider: PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science. Study selection, data extraction and quality appraisal will be conducted independently by two reviewers. Data synthesis will consist of a qualitative analysis of the data. Funding of the review was confirmed in August 2013 by the Ministry of Health, Welfare and Sport of the Netherlands.
DISCUSSION: This review will contribute to the knowledge on effects of physician substitution in healthcare for older people and factors that influence the outcomes. This knowledge will guide professionals and policy administrators in their decisions to optimize healthcare for older people.
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More information
Accepted/In Press date: 24 July 2015
e-pub ahead of print date: 18 September 2015
Keywords:
long-term care facilities, nurse practitioner, physician assistant, physician substitution, primary healthcare for older people, systematic review
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 380950
URI: http://eprints.soton.ac.uk/id/eprint/380950
ISSN: 0309-2402
PURE UUID: 67dd3670-61ae-49aa-b450-87cae468796a
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Date deposited: 21 Sep 2015 13:58
Last modified: 15 Mar 2024 03:41
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Contributors
Author:
M.H. Lovink
Author:
A. Persoon
Author:
A.J.A.H. van Vught
Author:
R.T.C.M. Koopmans
Author:
M.G.H. Laurant
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