¶ … Quality of Care Provided by Nurse Practitioners Cost and quality of healthcare access are two inter-related concepts that are central to the healthcare debate in the United States of America. The study will compare the effectiveness of quality and costs between NP and physicians. To achieve this purpose, the study will be guided y the following research questions; how does the cost of care provided by nurse practitioners compare to that of physicians: and how is the quality of care provided by nurse practitioners? The Jean Watson's Theory of Human Caring is adopted for this study. The study will be conducted in five different hospitals that have health services being provided by both NP and physicians. Study participants will be selected from hospital databases with the help of hospital staff to establish which patients will be more suited for the study. Research questionnaires will be used for data collections. The data collected will be analyzed through statistical program (SPSS, 2015 version) and descriptive analysis.

Purpose of Study

Cost and quality of healthcare access are two inter-related concepts that are central to the healthcare debate in the United States of America (Stanik-Hutt et al., 2013). To contribute to this debate, this study narrows down to the costs and quality of care delivered by nursing practitioners (NP). In particular, the study will compare the effectiveness of quality and costs between NP and physicians. To achieve this purpose, the study will be guided y the following research questions.

Research Questions

Two research questions have been set towards realization of the study purpose;

i. How does the cost of care provided by nurse practitioners compare to that of physicians?

ii. How is the quality of care provided by nurse practitioners?

Literature Review

According to Fletcher, Copeland and Lowery (2011), nursing practitioners can provide primary care that is underutilized within the healthcare environment. By acquiring skills in patient care management and physical assessment, NP can become primary care providers delivering services such as diagnosing, ambulatory care settings and providing treatments for a variety of health problems. Based on this skill set, NPs are expected to provide services that are less costly. Fletcher et al. (2011) reveals that the number of Veterans who seek for the primary healthcare services from nursing practitioners since 1996 has increased by more than 200%, which is attributed to high quality and cost-effective services.

Litaker, Mion and Planavsky (2003), demonstrate that there are modest incremental costs for a complementary team approach for the management of chronic disease. The authors reveal that intervention of NPs and medical practitioners increases HDL-c prevalence by 7%, however, HbA1c for diabetes patients reduces from 7.9% to 7.0%. The microvascular complications were reduced by 25% and a reduction of 16% for non-fatal, fatal sudden death and

Despite cost effectiveness carried out for NPs, the authors did not include personnel costs in their evaluation.
Allen et al. (2014) studied the cost-effectiveness of an intervention of nursing practitioners on patients suffering from CVD (cardiovascular disease). While the evidence-based practice to manage CVD is available, however, patient adherence to the therapies is slow. The authors argue that nursing practitioners can assist in providing the quality care at lower costs similar to the healthcare services delivered by other health care professionals. With the intervention of the nursing practitioners, the authors calculate the total costs per patients to manage the CVD. The outcome of the study reveals that the total costs per patient are $627. Moreover, the cost effectiveness shows that there is $157 reduction in cost for 1% drop in the systolic blood pressure. Moreover, $190 decline in cost for 1% drop in the diastolic blood pressure. Additionally, there is $149 decline in the cost of 1% per drop of HbA1c. A $40 decline in costs in 1% drop in LDL cholesterol is also recorded. The outcome of their research shows that management of CVD by NP is cost-effective for patients suffering from the high risk of CVD.

Kapu, Kleinpell & Pilon (2014) investigated the financial impact of NPs on inpatients at Vanderbilt University Hospital. The investigation was carried out based on the national initiatives targeting the cost effectiveness of NPs in the optimal healthcare environment because the health administrators believe that NPs can deliver cost savings as well as reducing costs of administration. The authors analyze the ROI (return on investment) after adding five teams of NPs. Software is used to evaluate the length of stay, and NPs quality metrics. The data collected was compared with the previous year's data. The finding of the research reveals that NPs demonstrated a huge decline in costs revealing that NPs used fewer resources in delivering a standardized quality of care.

Even though there's significant research on the quality and costs of healthcare provided by NP, research is still necessary based on the fact that, healthcare delivery is dynamic as healthcare services and technology used in healthcare changes continuously. With specificity to the U.S. healthcare system, this research is necessary to unearth the effects of healthcare policy changes in the country.

Theoretical framework

The Jean Watson's Theory of Human Caring is adopted for this study. The theory asserts that a human being cannot be healed as an object, but rather, as a part of an environment, nature, and the larger universe (Ozan, Okumus & Lash, 2015). This study deals with environmental issues; cost and quality of care, which are considered to influence healing through satisfaction perceived by a patient. The objective of the theory is to establish a harmonious balance between health and the illness experience of a person, which is essentially, by considering cost…