Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience
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Abstract
Objective: This study aims to evaluate the impact of a primary care nurse practitioner (NP)-led clinic model piloted in British Columbia (Canada) on patients’ health and care experience. Design: The study relies on a quasi-experimental longitudinal design based on a pre-and-post survey of patients receiving care in NP-led clinics. The prerostering survey (T0) was focused on patients’ health status and care experiences preceding being rostered to the NP clinic. One year later, patients were asked to complete a similar survey (T1) focused on the care experiences with the NP clinic. Setting: To solve recurring problems related to poor primary care accessibility, British Columbia opened four pilot NP-led clinics in 2020. Each clinic has the equivalent of approximately six full-time NPs, four other clinicians plus support staff. Clinics are located in four cities ranging from urban to suburban. Participants: Recruitment was conducted by the clinic’s clerical staff or by their care provider. A total of 437 usable T0 surveys and 254 matched and usable T1 surveys were collected. Primary outcome measures: The survey instrument was focused on five core dimensions of patients’ primary care experience (accessibility, continuity, comprehensiveness, responsiveness and outcomes of care) as well as on the SF-12 Short-form Health Survey. Results: Scores for all dimensions of patients’ primary care experience increased significantly: accessibility (T0=5.9, T1=7.9, p<0.001), continuity (T0=5.5, T1=8.8, p<0.001), comprehensiveness (T0=5.6, T1=8.4, p<0.001), responsiveness (T0=7.2, T1=9.5, p<0.001), outcomes of care (T0=5.0, T1=8.3, p<0.001). SF-12 Physical health T-scores also rose significantly (T0=44.8, T1=47.6, p<0.001) but no changes we found in the mental health T scores (T0=45.8, T1=46.3 p=0.709). Conclusions: Our results suggest that the NP-led primary care model studied here likely constitutes an effective approach to improve primary care accessibility and quality.
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Parallel research on patients' socio-demographic profile and care experience before joining NP-PCCs, and research on patients' health and care experience in NP-PCCs, suggest that the NP-PCC model also constitutes an effective way to address current problems in accessing good quality longitudinal care in BC.
“Further, parallel research focused on the socio-demographic profile of patients and their care experience before joining the NP-PCCs 60 as well as research on patients’ health and care experience in NP-PCCs 59 suggest that the NP-PCC model also constitutes an effective way to address current problems in accessing good quality longitudinal care in BC.”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [59]
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- Authors
- Contandriopoulos, D., Bertoni, K., Duhoux, A., & Randhawa, G. K.
- Affiliations
- University of Victoria (CA)
- Université de Montréal (CA)
- Corresponding author
- Contandriopoulos, Damien
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2023-10
- Volume
- 13
- Issue
- 10
- Pages
- e072812
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC10603457
- OpenAlex
- W4387784590
- Cited by
- 3
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Nurses and Nurse Practitioners of British Columbia (N/A)
- 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 › Patient Satisfaction in Healthcare
- Keywords
- nurse practitioner-led clinic, primary care, patient experience, primary care access, continuity of care, comprehensiveness of care, health care outcomes, physical health, mental health, health status, British Columbia
- MeSH terms
- British Columbia, Humans, Nurse Practitioners, Primary Health Care, Surveys and Questionnaires
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