Nurse practitioners substituting for general practitioners: randomized controlled trial
Abstract
Title. Nurse practitioners substituting for general practitioners: randomized controlled trial. Aim. This paper is a report of a study conducted to evaluate process and outcomes of care provided to patients with common complaints by general practitioners or specially trained nurse practitioners as first point of contact. Background. Studies in the United States of America and Great Britain show that substituting nurse practitioners for general practitioners results in higher patient satisfaction and higher quality of care. As the American and British healthcare system and settings differ from that in the Netherlands, a Dutch trial was conducted. Methods. A total of 1501 patients in 15 general practices were randomized to consultation by a general practitioner or a nurse practitioner. Data were collected over a 6‐month period in 2006 by means of questionnaires, extracting medical records from practice computer systems and recording the length of consultations. Findings. In both groups, the patients highly appreciated the quality of care. No statistically significant differences were found in health status, medical resource consumption and compliance of practical guidelines in primary care in the Netherlands. Patients in the NP intervention group were more often invited to re‐attend, had more follow‐up consultations and their consultations took statistically significantly longer. Conclusion. Nurse practitioners and general practitioners provide comparable care. Our findings support an increased involvement of specially trained nurse practitioners in the Dutch primary care and contribute to knowledge of the effectiveness of care provision by nurse practitioners from a national and international perspective.
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Measurable clinical outcomes are systematically found to be equivalent to those produced by medical models, though patient satisfaction tends to be higher for nurse-provided services.
“Measurable clinical outcomes are systematically found to be equivalent11,18,19,23,27-32 to those produced by medical models, though patient satisfaction tends to be higher for nurse-provided services.11,19,21,26,27,29,30,33,34”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [28]
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- Authors
- Dierick‐van Daele, A. T. M., Metsemakers, J. F. M., Derckx, E. W. C. C., Spreeuwenberg, C., & Vrijhoef, H. J. M.
- Affiliations
- Maastricht University (NL)
- Maastricht University Medical Centre (NL)
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2009-01-15
- Volume
- 65
- Issue
- 2
- Pages
- 391-401
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- OpenAlex
- W2129361092
- Cited by
- 170
- References
- 27
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 9 · 2023: 2 · 2022: 3 · 2021: 14 · 2020: 6 · 2019: 14 · 2018: 10 · 2017: 9 · 2016: 13 · 2015: 21 · 2014: 17 · 2013: 13 · 2012: 7
- FWCI
- 17.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Advanced Nursing (publishedVersion)
- Research portal (Tilburg University) (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Keywords
- nurse practitioners, general practitioners, primary care, first point of contact, common complaints, quality of care, patient satisfaction, consultation time, follow-up visits, guideline adherence, Dutch primary care
- MeSH terms
- Family Practice, Humans, Netherlands, Nurse Practitioners, Quality of Health Care, Surveys and Questionnaires, Reproducibility of Results, Patient Satisfaction, Outcome Assessment, Health Care, Personnel Delegation
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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