A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes
The role of advanced practice providers has expanded in the hospital setting. However, little data exist examining the impact of these providers. Our purpose was to determine the effect of adding nurse practitioners in a complementary role on the quality and efficiency of care of hospitalized patien...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Nursing Reports |
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| Online Access: | https://www.mdpi.com/2039-4403/11/1/3 |
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| author | Manish S. Patel Lauren C. Hogshire Helaine Noveck Michael B. Steinberg Donald R. Hoover Jane Rosenfeld Akanksha Arya Jeffrey L. Carson |
| author_facet | Manish S. Patel Lauren C. Hogshire Helaine Noveck Michael B. Steinberg Donald R. Hoover Jane Rosenfeld Akanksha Arya Jeffrey L. Carson |
| author_sort | Manish S. Patel |
| collection | DOAJ |
| description | The role of advanced practice providers has expanded in the hospital setting. However, little data exist examining the impact of these providers. Our purpose was to determine the effect of adding nurse practitioners in a complementary role on the quality and efficiency of care of hospitalized patients. A retrospective cohort study evaluated adult patients admitted by private physicians (without house staff or non-physician providers) to a general medical-surgical unit in an academic medical center. The admissions department allocated patients as beds became available and nurse practitioners were assigned to patients until their caseload was reached. Outcomes included length of hospital stay, in-hospital mortality, admission costs, 30-day readmissions, transfer to a more intensive care level, and discharge order time. Of the 382 patients included in this study, 263 were assigned to the nurse practitioner group. Hospital mortality was lower in the nurse practitioner group [OR 0.11 (95% CI 0.02–0.51)] as was transfer to more intensive care level [OR 0.39 (95% CI 0.20–0.75)]; however, the nurse practitioner group had longer length of stay (geometric mean = 5.80 days for nurse practitioners, 3.63 days for no nurse practitioners; <i>p</i> < 0.0001) and higher cost per patient (geometric mean = USD 6631 vs. USD 5121; <i>p</i> = 0.005). The results were unchanged when models were adjusted for potential confounders. Adding nurse practitioners can yield improved clinical outcomes (lower hospital mortality and fewer transfers to intensive care), but with a potential economic expense (longer hospital stays and higher costs). |
| first_indexed | 2024-03-09T05:10:06Z |
| format | Article |
| id | doaj.art-6e6ea4cd106343aa872e02ce2efea61c |
| institution | Directory Open Access Journal |
| issn | 2039-439X 2039-4403 |
| language | English |
| last_indexed | 2024-03-09T05:10:06Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nursing Reports |
| spelling | doaj.art-6e6ea4cd106343aa872e02ce2efea61c2023-12-03T12:50:13ZengMDPI AGNursing Reports2039-439X2039-44032021-01-01111283510.3390/nursrep11010003A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient OutcomesManish S. Patel0Lauren C. Hogshire1Helaine Noveck2Michael B. Steinberg3Donald R. Hoover4Jane Rosenfeld5Akanksha Arya6Jeffrey L. Carson7Division of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USADivision of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USADivision of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USADivision of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USADepartment of Statistics and Institute for Health, Healthcare Policy and Aging Research, Rutgers University, Piscataway, NJ 08854, USADivision of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USADepartment of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USADivision of General Internal Medicine, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USAThe role of advanced practice providers has expanded in the hospital setting. However, little data exist examining the impact of these providers. Our purpose was to determine the effect of adding nurse practitioners in a complementary role on the quality and efficiency of care of hospitalized patients. A retrospective cohort study evaluated adult patients admitted by private physicians (without house staff or non-physician providers) to a general medical-surgical unit in an academic medical center. The admissions department allocated patients as beds became available and nurse practitioners were assigned to patients until their caseload was reached. Outcomes included length of hospital stay, in-hospital mortality, admission costs, 30-day readmissions, transfer to a more intensive care level, and discharge order time. Of the 382 patients included in this study, 263 were assigned to the nurse practitioner group. Hospital mortality was lower in the nurse practitioner group [OR 0.11 (95% CI 0.02–0.51)] as was transfer to more intensive care level [OR 0.39 (95% CI 0.20–0.75)]; however, the nurse practitioner group had longer length of stay (geometric mean = 5.80 days for nurse practitioners, 3.63 days for no nurse practitioners; <i>p</i> < 0.0001) and higher cost per patient (geometric mean = USD 6631 vs. USD 5121; <i>p</i> = 0.005). The results were unchanged when models were adjusted for potential confounders. Adding nurse practitioners can yield improved clinical outcomes (lower hospital mortality and fewer transfers to intensive care), but with a potential economic expense (longer hospital stays and higher costs).https://www.mdpi.com/2039-4403/11/1/3nurse practitionerinpatientoutcomesquality of carehospital |
| spellingShingle | Manish S. Patel Lauren C. Hogshire Helaine Noveck Michael B. Steinberg Donald R. Hoover Jane Rosenfeld Akanksha Arya Jeffrey L. Carson A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes Nursing Reports nurse practitioner inpatient outcomes quality of care hospital |
| title | A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes |
| title_full | A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes |
| title_fullStr | A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes |
| title_full_unstemmed | A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes |
| title_short | A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes |
| title_sort | retrospective cohort study of the impact of nurse practitioners on hospitalized patient outcomes |
| topic | nurse practitioner inpatient outcomes quality of care hospital |
| url | https://www.mdpi.com/2039-4403/11/1/3 |
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