Is an expanded nurse role economically viable?

Lee, Tae Wha; Ko, Il Sun; Jeong, Seung-Young

doi:10.1111/j.1365-2648.2004.03021.x

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Consultation length was not considered in two of the economic evaluations that found role substitution to be cost-effective. 14,17 Although the results reported lower unit costs in these studies, nurse and CHP consultations may have been significantly longer than GP consultations, so actual costs may have been higher for the allied health professional groups. Only one of the included studies explicitly provided information on patient recall including contacts made with healthcare professionals over the study period.…”

Section: Strengths and Limitationsmentioning

confidence: 66%

“…A good-quality cost-minimisation analysis from South Korea compared the delivery of primary care services by community health practitioners (CHPs) in remote communities with equivalent care delivered by physicians in inner-city clinics (no CHP services) 14 (Table 3). CHPs were described as registered nurses responsible for the delivery of primary care, who had received 6 months of special training.…”

Section: Community Health Practitionersmentioning

confidence: 99%

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General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care

Anthony¹,

Surgey²,

Hiscock³

et al. 2019

Br J Gen Pract

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BackgroundPrevious systematic reviews have found that nurses and pharmacists can provide equivalent, or higher, quality of care for some tasks performed by GPs in primary care. There is a lack of economic evidence for this substitution.AimTo explore the costs and outcomes of role substitution between GPs and nurses, pharmacists, and allied health professionals in primary care.Design and settingA systematic review of economic evaluations exploring role substitution of allied health professionals in primary care was conducted. Role substitution was defined as ‘the substitution of work that was previously completed by a GP in the past and is now completed by a nurse or allied health professional’.MethodThe following databases were searched: Ovid MEDLINE, CINAHL, Cochrane Library, National Institute for Health and Care Excellence (NICE), and the Centre for Reviews and Dissemination. The review followed guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsSix economic evaluations were identified. There was some limited evidence that nurse-led care for common minor health problems was cost-effective compared with GP care, and that nurse-led interventions for chronic fatigue syndrome and pharmacy-led services for the medicines management of coronary heart disease and chronic pain were not. In South Korea, community health practitioners delivered primary care services for half the cost of physicians. The review did not identify studies for other allied health professionals such as physiotherapists and occupational therapists.ConclusionThere is limited economic evidence for role substitution in primary care; more economic evaluations are needed.

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Section: Strengths and Limitationsmentioning

confidence: 66%

Section: Community Health Practitionersmentioning

confidence: 99%

General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care

Anthony¹,

Surgey²,

Hiscock³

et al. 2019

Br J Gen Pract

View full text Add to dashboard Cite

show abstract

“…The Takapau Health Centre and its outreach Norsewood & Districts Health Centre in New Zealand are similar to Victoria's BNCs, relying primarily on their nurses with limited medical support (Litchfield 2004). Korea has similar services in remote and isolated areas that are delivered by community health practitioners who are specially trained Registered Nurses (Lee et al. 2004).…”

Section: Discussionmentioning

confidence: 99%

Review of small rural health services in Victoria: how does the nursing‐medical division of labour affect access to emergency care?

Sullivan

Francis²,

Hegney

2008

Journal of Clinical Nursing

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AimsThis paper is based on a review of the Australian and International literature relating to the nursingmedical division of labour. It also explores how the division of labour affects patient access to emergency care in small rural health services in Victoria, Australia. BackgroundThe paper describes the future Australian health workforce and the implications for rural Victoria. The concept of division of labour and how it relates to nursing and medicine is critically reviewed. Two forms of division of labour emerge -traditional and negotiated division of labour. Key themes are drawn from the literature that describes the impact of a traditional form of division of labour in a rural context. MethodsThis paper is based on a review of the Australian and international literature, including grey literature, on the subject of rural emergency services, professional boundaries and roles, division of labour, professional relationships and power and the Australian health workforce. ResultsIn Australia, the contracting workforce means that traditional divisions of labour between health professionals cannot be sustained without reducing access to emergency care in rural Victoria. A traditional division of labour results in rural health services that are vulnerable to slight shifts in the medical workforce, unsafe services and recruitment and retention problems. A negotiated form of division of labour provides a practical alternative. ConclusionA division of labour that is negotiated between doctors and nurses and supported by a legal and clinical governance framework, is needed to support rural emergency services. The published evidence suggests that this situation currently does not exist in Victoria. Strategies are offered for creating and supporting a negotiated division of labour.Relevance to clinical practice This paper offers some strategies for establishing a negotiated division of labour between doctors and nurses in rural emergency care.

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“…Indeed, Chang et al. (1999), Lee et al. (2004) and Gardner and Gardner (2005), identify that ANPs have been providing a beneficial contribution and filling a gap in healthcare services.…”

Section: Collaboration: the Synergistic Way Forwardmentioning

confidence: 99%

Advanced nursing practice: an idea whose time has come

Callaghan

2007

Journal of Clinical Nursing

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Nurses working at an advanced level are striving to develop their expertise, initiate nurse-led services and practice, in collaboration with other professionals in an effort to provide the highest quality care to the patient. Although the idea of the advanced nurse practitioner is relatively new to nursing in Ireland, it is the result of an idea whose time has come and there is nothing more powerful than an idea whose time has come.

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Is an expanded nurse role economically viable?

Abstract: The results provide evidence of the economic validity of the CHP's role in the public sector, where there is no net income to serve as a policy guideline. The conclusion can be drawn that CHP services are more effective than physician services (or 'no CHP services').

Cited by 8 publications

References 15 publications

General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care

General medical services by non-medical health professionals: a systematic quantitative review of economic evaluations in primary care

Review of small rural health services in Victoria: how does the nursing‐medical division of labour affect access to emergency care?

Advanced nursing practice: an idea whose time has come

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