Primary Care and Nursing Article Review

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Nursing Practitioners

In the United States and the United Kingdom, NP (Nursing practitioners) are being used as a point of contact to deliver primary care for patients. Trained nursing practitioners who can deliver in-person primary healthcare services for patients are gradually increasing. While patients provide positive feedback about the nursing roles, there is still a debate whether nursing practitioners can deliver a cost effectiveness for a patients' treatment compared with other healthcare professionals, and deliver quality healthcare. (Venning, et al. 2000).

The objective of this study is to review the literature that provides the cost effectiveness of nursing practitioners. The study reviews six different literature to enhance a greater understanding of the cost effectiveness of nursing practitioners in the healthcare environment.

Synthesis and Analysis of the Articles

Venning, et al. (2000) provide a random trial on the cost effectiveness of the nursing practitioners in the United Kingdom sampling NPs in 20 geographical regions in the United Kingdom. The evaluation was carried out on the nursing practitioners who have completed a two-year program in nursing education. The evaluation was also carried for nurses who have BSc or Master degree in Nursing and were qualified as nurses for at least 3 years and seeing patients for at least two years. Venning, et al. (2000) collect data from 1,316 patients who seek for the service of nurses to evaluate the effectiveness of nursing practitioners. The outcome of the evaluation reveals that satisfactions among patients were significantly higher showing that the benefits that patients secure from nurses are higher than the costs incurred for the services. Generally, patient satisfactions are critical in assessing the cost effectiveness of the services of nursing practitioners. It is revealed that patients turn around with nursing practitioners are higher than general practitioners because the health consultations costs for nurses are 12.5% lower than for general practitioners.

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Fletcher, Copeland, Lowery, (2011) support the argument of the previous authors by explaining that 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. The authors evaluate the cost effectiveness of nursing practitioners in the Department of Veterans in the United States. The study verifies the quality care for outpatient services, medication prescriptions, and laboratory results services. The outcome of the research reveals that the number of Veterans who seek for the primary healthcare services from nursing practitioners since 1996 has increased by more than 200%. For example, 75% of patients agree using the services of NP in 1996, however, the number of patients using the NP services increased to 90% in 1999. Through clinical practice and on-going education, the NPs are able to deliver "a wide range of healthcare services including diagnosis and treatment of acute conditions." (Fletcher, Copeland, Lowery, 2011 p 794).

Despite the analysis of the cost-effectiveness of NPs carried out by the previous studies, the articles did not compare the direct costs versus direct healthcare benefits derived from patients. Litaker, Mion, Planavsky, (2003) is able to address this shortcoming by demonstrating 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 myocardial infarction were recorded. Despite cost effectiveness carried out for NPs, the authors did.....

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