Substitution of general practitioners by nurse practitioners in out-of-hours primary care: a quasi experimental study
Substitution of general practitioners by nurse practitioners in out-of-hours primary care: a quasi experimental study
Aim : To provide insight into the impact of substituting general practitioners with nurse practitioners in out-of-hours services on (1) the number of patients, and (2) general practitioners’ caseload (patient characteristics, urgency levels, types of complaints).
Background: General practitioners’ workload during out-of-hours care is high, the number of hours they work out-of-hours has increased, which raises concerns about maintaining quality of care. One response to these challenges is shifting care to nurse practitioners.
Design: Quasi-experimental study comparing differences between and within out-of-hours teams; experimental: 1 nurse practitioner and 4 general practitioners; control: 5 general practitioners.
Methods: Data of 12,092 patients from one general practitioner cooperative were extracted from medical records between April 2011 and July 2012.
Results: The number of patients was similar in the two study arms. In the experimental arm the nurse practitioner saw on average 16.3% of the patients and each general practitioner on average 20.9% of the patients. General practitioners treated more: older patients; higher urgency levels; and digestive, cardiovascular, and neurological complaints. Nurse practitioners treated more patients with skin and respiratory complaints . Substitution did not lead to a meaningful increase of general practitioners’ caseload.
Conclusion: The results show that NPs can have a valuable contribution to patient care during out-of-hours. The patients managed and care provided by NPs is roughly the same as GPs’. In areas with a shortage of GPs, administrators could consider to introduce qualified nurses who are competent to independently treat patients with a broad range of complaints to offer timely care to patients with acute problems.
1813-1824
Van Der Biezen, M.
3932d6b0-08d7-4ccc-8796-945029514435
Schoonhoven, L.
46a2705b-c657-409b-b9da-329d5b1b02de
Wijers, N.
2348d132-66a3-4079-aa9e-46a8b3b7b5ae
Van Der Burgt, M.
f74b6fbf-9fd1-43dd-8ba4-608243086009
Wensing, M.
1746439a-20ad-468d-84e1-f3cf3008a9ed
Laurant, M.
c3813942-770c-4e11-8a67-8aca9940f0e7
August 2016
Van Der Biezen, M.
3932d6b0-08d7-4ccc-8796-945029514435
Schoonhoven, L.
46a2705b-c657-409b-b9da-329d5b1b02de
Wijers, N.
2348d132-66a3-4079-aa9e-46a8b3b7b5ae
Van Der Burgt, M.
f74b6fbf-9fd1-43dd-8ba4-608243086009
Wensing, M.
1746439a-20ad-468d-84e1-f3cf3008a9ed
Laurant, M.
c3813942-770c-4e11-8a67-8aca9940f0e7
Van Der Biezen, M., Schoonhoven, L., Wijers, N., Van Der Burgt, M., Wensing, M. and Laurant, M.
(2016)
Substitution of general practitioners by nurse practitioners in out-of-hours primary care: a quasi experimental study.
Journal of Advanced Nursing, 72 (8), .
(doi:10.1111/jan.12954).
Abstract
Aim : To provide insight into the impact of substituting general practitioners with nurse practitioners in out-of-hours services on (1) the number of patients, and (2) general practitioners’ caseload (patient characteristics, urgency levels, types of complaints).
Background: General practitioners’ workload during out-of-hours care is high, the number of hours they work out-of-hours has increased, which raises concerns about maintaining quality of care. One response to these challenges is shifting care to nurse practitioners.
Design: Quasi-experimental study comparing differences between and within out-of-hours teams; experimental: 1 nurse practitioner and 4 general practitioners; control: 5 general practitioners.
Methods: Data of 12,092 patients from one general practitioner cooperative were extracted from medical records between April 2011 and July 2012.
Results: The number of patients was similar in the two study arms. In the experimental arm the nurse practitioner saw on average 16.3% of the patients and each general practitioner on average 20.9% of the patients. General practitioners treated more: older patients; higher urgency levels; and digestive, cardiovascular, and neurological complaints. Nurse practitioners treated more patients with skin and respiratory complaints . Substitution did not lead to a meaningful increase of general practitioners’ caseload.
Conclusion: The results show that NPs can have a valuable contribution to patient care during out-of-hours. The patients managed and care provided by NPs is roughly the same as GPs’. In areas with a shortage of GPs, administrators could consider to introduce qualified nurses who are competent to independently treat patients with a broad range of complaints to offer timely care to patients with acute problems.
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Accepted/In Press date: January 2015
e-pub ahead of print date: 11 March 2016
Published date: August 2016
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 386898
URI: http://eprints.soton.ac.uk/id/eprint/386898
ISSN: 0309-2402
PURE UUID: e38c43df-746a-4476-8637-38f5b49e3099
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Date deposited: 05 Feb 2016 11:53
Last modified: 15 Mar 2024 03:41
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Contributors
Author:
M. Van Der Biezen
Author:
N. Wijers
Author:
M. Van Der Burgt
Author:
M. Wensing
Author:
M. Laurant
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