Nurse practitioners as an underutilized resource for health reform: Evidence‐based demonstrations of cost‐effectiveness
Open accessAbstract
Healthcare reform in 2009 was motivated by an imperative to reduce the relentless increase in spending on medical care. Many efforts to solve the problem focused on applying proven principles of evidence‐based practice and cost‐effectiveness to find the least‐expensive way to produce a specific clinical service of acceptable quality. This paper combines economic analysis and reviews published literature to show how the goals of healthcare reform can be accomplished by allowing independently licensed nurse practitioners to provide their wide range of services directly to patients in a variety of clinical settings. The paper presents extensive, consistent evidence that nurse practitioners provide care of equal or better quality at lower cost than comparable services provided by other qualified health professionals.
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Nineteen studies were ex-post economic evaluations; of those, 17 were cost-effectiveness analyses.
“Nineteen studies were ex-post economic evaluations of which 17 were CEAs with one CUA [7, 12, 14, 15, 17] [18–30, 33].”
From Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review (2019) · cites this paper as [14]
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- Authors
- Bauer, J. C.
- Corresponding author
- Bauer, Jeffrey C.
- Venue
- Journal of the American Academy of Nurse Practitioners
- Publisher
- Wiley
- Published
- 2010-04
- Volume
- 22
- Issue
- 4
- Pages
- 228-231
- ISSN
- 1041-2972 (ISSN-L)
- 1745-7599
- OpenAlex
- W2029769398
- Cited by
- 147
- References
- 0
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 4 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 16 · 2018: 8 · 2017: 9 · 2016: 10 · 2015: 20 · 2014: 13 · 2013: 9 · 2012: 16
- FWCI
- 22.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Nurse Practitioners (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- nurse practitioners, health care reform, cost-effectiveness, health care costs, quality of care, evidence-based practice, primary care, health care spending
- MeSH terms
- Cost-Benefit Analysis, Health Policy, Humans, Income, Nurse Practitioners, Primary Health Care, Quality of Health Care, Reimbursement Mechanisms, United States, Nursing Evaluation Research, Professional Autonomy, Health Care Reform, Nurse's Role, Government Regulation, Evidence-Based Nursing
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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