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The Impact of Nonphysician Clinicians
Abstract
Health care is changing rapidly. Unacceptable variations in service access and quality of health care and pressures to contain costs have led to the redefinition of professional roles. The roles of nonphysician clinicians (nurses, physician assistants, and pharmacists) have been extended to the medical domain. It is expected that such revision of roles will improve health care effectiveness and efficiency. The evidence suggests that nonphysician clinicians working as substitutes or supplements for physicians in defined areas of care can maintain and often improve the quality of care and outcomes for patients. The effect on health care costs is mixed, with savings dependent on the context of care and specific nature of role revision. The evidence base underpinning these conclusions is strongest for nurses with a marked paucity of research into pharmacists and physician assistants. More robust evaluative studies into role revision are needed, particularly with regard to economic impacts, before definitive conclusions can be drawn.
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From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [20]
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From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [20]
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Metadata
- Authors
- Laurant, M., Harmsen, M., Wollersheim, H., Grol, R., Faber, M., & Sibbald, B.
- Affiliations
- Radboud University Medical Center (NL)
- University of Manchester (GB)
- Venue
- Medical Care Research and Review
- Publisher
- SAGE Publications
- Published
- 2009-10-30
- Volume
- 66
- Issue
- 6_suppl
- Pages
- 36S-89S
- ISSN
- 1077-5587 (ISSN-L)
- 1552-6801
- OpenAlex
- W2129916293
- Cited by
- 166
- References
- 69
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 8 · 2022: 2 · 2021: 5 · 2020: 10 · 2019: 15 · 2018: 14 · 2017: 19 · 2016: 17 · 2015: 16 · 2014: 15 · 2013: 16 · 2012: 9
- FWCI
- 13.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care Research and Review (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- non-physician clinicians, nurse practitioners, physician assistants, pharmacists, professional role expansion, health care costs, quality of care, health care access, health care delivery
- MeSH terms
- Cost-Benefit Analysis, Health Personnel, Health Policy, Health Services, Humans, Pharmacists, Physician's Role, Quality of Health Care
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