Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review
Introduction: Shifting specialist care from the hospital to primary care/community care (also called primary care plus) is proposed as one option to reduce the increasing healthcare costs, improve quality of care and accessibility. The aim of this systematic review was to get insight in primary care...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2021-02-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | https://www.ijic.org/articles/5485 |
| _version_ | 1818850709040267264 |
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| author | R. M. A. van Erp A. L. van Doorn G. T. van den Brink J. W. B. Peters M. G. H. Laurant A. J. van Vught |
| author_facet | R. M. A. van Erp A. L. van Doorn G. T. van den Brink J. W. B. Peters M. G. H. Laurant A. J. van Vught |
| author_sort | R. M. A. van Erp |
| collection | DOAJ |
| description | Introduction: Shifting specialist care from the hospital to primary care/community care (also called primary care plus) is proposed as one option to reduce the increasing healthcare costs, improve quality of care and accessibility. The aim of this systematic review was to get insight in primary care plus provided by physician assistants or nurse practitioners. Methods: Scientific databases and reference list were searched. Hits were screened on title/abstract and full text. Studies published between 1990–2018 with any study design were included. Risk of bias assessment was performed using QualSyst tool. Results: Search resulted in 5.848 hits, 15 studies were included. Studies investigated nurse practitioners only. Primary care plus was at least equally effective as hospital care (patient-related outcomes). The number of admission/referral rates was significantly reduced in favor of primary care plus. Barriers to implement primary care plus included obtaining equipment, structural funding, direct access to patient-data. Facilitators included multidisciplinary collaboration, medical specialist support, protocols. Conclusions and Discussion: Quality of care within primary care plus delivered by nurse practitioners appears to be guaranteed, at patient-level and professional-level, with better access to healthcare and fewer referrals to hospital. Most studies were of restricted methodological quality. Findings should be interpreted with caution. |
| first_indexed | 2024-12-19T06:53:26Z |
| format | Article |
| id | doaj.art-d0c7604dcc9240098d2100220b794086 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-19T06:53:26Z |
| publishDate | 2021-02-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-d0c7604dcc9240098d2100220b7940862022-12-21T20:31:38ZengUbiquity PressInternational Journal of Integrated Care1568-41562021-02-0121110.5334/ijic.54854992Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic ReviewR. M. A. van Erp0A. L. van Doorn1G. T. van den Brink2J. W. B. Peters3M. G. H. Laurant4A. J. van Vught5HAN University of Applied Sciences, Verlengde Groenestraat 75, 6525 EJ, NijmegenHAN University of Applied Sciences, Verlengde Groenestraat 75, 6525 EJ, NijmegenHAN University of Applied Sciences, Verlengde Groenestraat 75, 6525 EJ, NijmegenMaster Advanced Nursing Practice, HAN University of Applied Sciences, Groenewoudseweg 1, 6524 TM, NijmegenHAN University of Applied Sciences, Faculty of Health and Social Studies, Kapittelweg 33, 6525 EN, NijmegenHAN University of Applied Sciences, Faculty of Health and Social Studies, Kapittelweg 33, 6525 EN, NijmegenIntroduction: Shifting specialist care from the hospital to primary care/community care (also called primary care plus) is proposed as one option to reduce the increasing healthcare costs, improve quality of care and accessibility. The aim of this systematic review was to get insight in primary care plus provided by physician assistants or nurse practitioners. Methods: Scientific databases and reference list were searched. Hits were screened on title/abstract and full text. Studies published between 1990–2018 with any study design were included. Risk of bias assessment was performed using QualSyst tool. Results: Search resulted in 5.848 hits, 15 studies were included. Studies investigated nurse practitioners only. Primary care plus was at least equally effective as hospital care (patient-related outcomes). The number of admission/referral rates was significantly reduced in favor of primary care plus. Barriers to implement primary care plus included obtaining equipment, structural funding, direct access to patient-data. Facilitators included multidisciplinary collaboration, medical specialist support, protocols. Conclusions and Discussion: Quality of care within primary care plus delivered by nurse practitioners appears to be guaranteed, at patient-level and professional-level, with better access to healthcare and fewer referrals to hospital. Most studies were of restricted methodological quality. Findings should be interpreted with caution.https://www.ijic.org/articles/5485physician assistantsnurse practitionersprimary health caresystematic reviewsubstitution of careintegrated care |
| spellingShingle | R. M. A. van Erp A. L. van Doorn G. T. van den Brink J. W. B. Peters M. G. H. Laurant A. J. van Vught Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review International Journal of Integrated Care physician assistants nurse practitioners primary health care systematic review substitution of care integrated care |
| title | Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review |
| title_full | Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review |
| title_fullStr | Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review |
| title_full_unstemmed | Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review |
| title_short | Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review |
| title_sort | physician assistants and nurse practitioners in primary care plus a systematic review |
| topic | physician assistants nurse practitioners primary health care systematic review substitution of care integrated care |
| url | https://www.ijic.org/articles/5485 |
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