Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T16:27:46.194Z Has data issue: false hasContentIssue false
  • English
  • Français

Cost-Effective Primary Care Providers: An Important Component of Health Care Reform

Published online by Cambridge University Press:  10 March 2009

Patricia A. Prescott
Patricia A. Prescott
Affiliation:
University of Maryland
Get access Rights & Permissions [Opens in a new window]

Abstract

Planning for a cost-effective mix of providers is an important aspect of health care reform. Currently, there are too many specialists and insufficient numbers of primary care providers. Nurses in advanced practice roles are an important resource for expanding the nation's supply of primary care providers.

Type
Special Section: Assessing Nursing and Technology
Information
International Journal of Technology Assessment in Health Care , Volume 10 , Issue 2 , Spring 1994 , pp. 249 - 257
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Average staff doctor said to earn $139,700. Washington Post. Washington, DC, Wednesday, 02 24, 1993.Google Scholar
2.Becker, D., Fournier, A., & Gardner, L.A description of a means of improving ambulatory care in a large municipal teaching hospital: A new role of nurse practitioners. Medical Care, 1982, 20, 1046–50.CrossRefGoogle Scholar
3.Brown, D.Do physicians underutilize aids? Journal of Human Resources, 1988, 23, 343–55.Google Scholar
4.Brown, S., & Grimes, D.A meta-analysis of process of care, clinical outcomes, and cost-effectiveness of nurses in primary care roles: Nurse practitioners and certified nurse midwives. Paper prepared for The American Nurses’ Association, Division of Health Policy. Washington, DC, 1993.Google Scholar
5.Counsel on Graduate Medical Education. Third report. Division of Medicine, Health Resources & Services Administration, Public Health Service. Washington, DC: U.S. Department of Health and Human Services, 10 1992.Google Scholar
6.Cruikshank, B., Clow, T., & Seals, B.Pediatric nurse practitioner functions in the outpatient clinics of a tertiary care center. Medical Care, 1986, 24, 340–49.CrossRefGoogle ScholarPubMed
7.Denton, F., et al. Potential savings from the adoption of nurse practitioner technology in the Canadian health care system. Socio-Economic Planning Science, 1983, 17(4), 199–209.CrossRefGoogle ScholarPubMed
8.Department of Health and Human Services. Sixth report to the President and Congress on the status of health personnel in the United States. Washington, DC: U.S. Government Printing Office, 1988.Google Scholar
9.Department of Health and Human Services. Secretary's Commission on Nursing. Final report, vol. I. Washington, DC: U.S. Government Printing Office, 1988.Google Scholar
10.Diers, D., Hamman, A., & Molde, S.Complexity of ambulatory care: Nurse practitioner and physician caseloads. Nursing Research, 1986, 35, 310–14.CrossRefGoogle ScholarPubMed
11.Everitt, D., Avorn, J., & Baker, M.The use of medication by physicians, nurse practitioners, and older patients. Gerontologist, 1987, 27, 34A.Google Scholar
12.GMENAC. Report of the Graduate Medical Education National Advisory Committee, vols. I-VIII. Washington, DC: U.S. Government Printing Office, 1980.Google Scholar
13.Ginzberg, E.Physician supply policies and health reform. Journal of the American Medical Association, 1992, 268, 3115–18.CrossRefGoogle ScholarPubMed
14.Goldstein, H., & Horowitz, M.Utilization of health personnel: A five hospital study. Germantown, MD: Aspen Systems Corp., 1978.Google Scholar
15.Graveley, E., & Littlefield, J.A cost-effectiveness analysis of three staffing models for the delivery of low risk prenatal care. American Journal of Public Health, 1992, 82,180–84.CrossRefGoogle ScholarPubMed
16.Hall, J., Palmer, H., Orav, J., et al. Performance quality, gender and professional role. A study of physicians and non-physicians in 16 ambulatory care practices. Medical Care, 1990, 28, 486–561.CrossRefGoogle Scholar
17.Knickman, J., Lipkin, M., Finkler, S., et al. The potential for using non-physicians to compensate for the reduced availability of residents. Academic Medicine, 1992, 67, 429–38.CrossRefGoogle ScholarPubMed
18.Mahoney, D.An economic analysis of the nurse practitioner role. Nurse Practitioner, 1988, 13, 44–52.CrossRefGoogle ScholarPubMed
19.McGrath, S.The cost-effectiveness of nurse practitioners. Nurse Practitioner, 1990, 15(7), 40–42.CrossRefGoogle ScholarPubMed
20.Nichols, L.Estimating costs of underusing advanced practice nurses. Nursing Economics, 1992, 10(5), 343–51.Google ScholarPubMed
21.Office of Technology Assessment, U.S. Congress. Nurse practitioners, physician assis tants, and certified nurse midwives: A policy analysis. Health Technology Case Study #37. Washington, DC: OTA, 1986.Google Scholar
22.Perrin, E. C., & Goodman, H. C.Telephone management of acute pediatric illnesses. New England Journal of Medicine, 1978, 298, 130–35.CrossRefGoogle ScholarPubMed
23.Poirier-Elliott, E.Cost-effectiveness of non-physician health care professionals. Nurse Practitioner, 1984, 9(10), 54–56.Google ScholarPubMed
24.Powers, M., Jalowiec, A., & Reichelt, P.Nurse practitioner and physician care compared for non-urgent emergency room patients. Nurse Practitioner, 1984, 9(2), 39–52.CrossRefGoogle Scholar
25.Prescott, P.Forecasting requirements for health care personnel. Nursing Economics, 1991, 9(1), 18–24.Google ScholarPubMed
26.Prescott, P. The nurse labor market: Considerations for the 1990's. In Aiken, L. & Fagin, C. (eds.), Charting nursing's future: Agenda for the 1990's. New York, NY: J. B Lippincott, 1992.Google Scholar
27.Ramsay, J., McKenzie, J., & Fish, D.Physicians and nurse practitioner: Do they provide equivalent health care? American Journal of Public Health, 1982, 72, 55–57.CrossRefGoogle ScholarPubMed
28.Record, J., et al. Staffing primary care in 1990: Physician replacement and cost savings, vol. 6. Springer Series on Health Care and Society. New York, NY: Springer Publishing Co., 1981.Google Scholar
29.Safriet, B.Health care dollars and regulatory sense: The role of advanced practice nursing. Yale Journal of Regulation, 1992, 9(2), 417–88.Google Scholar
30.Salkever, D., Skinner, E., Steinwachs, D., & Katz, H.Episode based efficiency comparisons for physicians and nurse practitioner. Medical Care, 1982, 20, 143–53.CrossRefGoogle Scholar
31.Silver, H., Murphy, M., & Gitterman, B.The hospital nurse practitioner in pediatrics: A new expanded role for staff nurses. Nurse Practitioner, 1984, 138, 237–39.Google Scholar
32.Spitzer, W.The nurse practitioner revisited: Slow death of a good idea. New England Journal of Medicine, 1984, 310, 1049–51.CrossRefGoogle ScholarPubMed
33.Spitzer, W., et al. The Burlington randomized trial of the nurse practitioner. New England Journal of Medicine, 1974, 290, 251–56.CrossRefGoogle ScholarPubMed
34.Steinwachs, D., Weiner, J., Shapiro, S., et al. A comparison of the requirements for primary care physicians in HMOs with projections made by the GMENAC. New England Journal of Medicine, 1986, 314, 217–22.CrossRefGoogle ScholarPubMed
35.University of Texas Medical Branch. 1990 national survey of hospital and medical school salaries. Galveston, TX: UTMB, 1992.Google Scholar
36.Ventura, M., et al. Information synthesis: Effectiveness of nurse practitioners, vol. I, technical report. NTIS # PB 85–101962.Springfield, VA: National Technical Information Service, 1985.Google Scholar
37.Young, A.Report III: Substitution activity and production function analysis. Study of the financing of graduate medical education. Washington, DC: Arthur Young, Inc. 1986.Google Scholar