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Nurse Practitioner Workforce Reaction Paper

Nurse Practitioners: Better Care Savings Crosspost: Nurse Practitioner Workforce

Nurse Practitioners: Potential Better Care Savings

Nurse Practitioners: Potential Better Care Savings

With passage of the Patient Protection and Affordable Care Act (ACA) of 2010 and its stated agenda for controlling the cost of healthcare in America, many are advocating for expansion of the nurse practitioner (NP) workforce and its scope of practice (Poghosyan, Lucero, Rauch, and Berkowitz, 2012). The concerns about current and projected healthcare costs are warranted. In 2009, the U.S. allocated just over 17% of its gross domestic product to health care spending, which is at least 5% above that spent by other Western nations (Squires, 2012). Half of this was spent through Medicare and Medicaid, which provides coverage for retirees, the disabled, and those living in poverty. This is important because the latter two patient populations are those traditionally served by NPs (Poghosyan, Lucero, Rauch, and Berkowitz, 2012).

Horrocks and colleagues (2002) conducted a systematic literature review of empirical studies that had investigated quality of care issues surrounding NPs and found no difference in health status, prescriptions written, return consultations, or referrals. However, NPs tended to spend significantly more time with patients and conduct more tests. This would probably explain why patients reported greater satisfaction with NP care.
A more recent systematic review of the literature encompassed 37 studies, many of which had been published since Horrock and colleagues (2002) conducted their study (Newhouse et al., 2011). Based on this analysis, NPs are equivalent to physicians in terms of patient satisfaction, health status, hypertension control, emergency department visits, hospitalizations, ventilation duration, length of hospital stay, and mortality; however, NP patients tended to control their serum glucose and lipid levels better. These findings suggest primary care provided by NPs is at least equal to that provided by…

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References

CDC (U.S. Centers for Disease Control and Prevention). (2011). National diabetes fact sheet, 2011. CDC.gov. Retrieved 25 Mar. 2013 from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

CHRT (Center for Healthcare Research & Transformation). (2010). The cost burden of disease. CHRT.org. Retrieved 25 Mar. 2013 from http://www.chrt.org/assets/price-of-care/CHRT-Issue-Brief-January-2010.pdf.

Horrocks, Sue, Anderson, Elizabeth, and Salisbury, Chris. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. British Medical Journal, 324, 819-823.

Newhouse, Robin P., Stanik-Hutt, Julie, White, Kathleen M., Johantgen, Meg, Bass, Eric B., Zangaro, George et al. (2011). Advanced practice nurse outcomes 1990-2008: A systematic review. Nursing Economics, 29(5), 230-250.
Squires, David A. (2012). Explaining high health care spending in the United States: An international comparison of supply, utilization, prices, and quality. The Commonwealth Fund. Retrieved 20 May, 2013 from http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/May/1595_Squires_explaining_high_hlt_care_spending_intl_brief.pdf.
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