Task-Shifting From Physicians to Nurses in Primary Care and its Impact on Resource Utilization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Task-shifting from physicians to nurses has gained increasing interest in health policy but little is known about its efficiency. This systematic review was conducted to compare resource utilization with task-shifting from physicians to nurses in primary care. Literature searches yielded 4,589 citations. Twenty studies comprising 13,171 participants met the inclusion criteria. Meta-analyses showed nurses had more return consultations and longer consultations than physicians but were similar in their use of referrals, prescriptions, or investigations. The evidence has limitations, but suggests that the effects may be influenced by the utilization of resources, context of care, available guidance, and supervision. Cost data suggest physician–nurse salary and physician’s time spent on supervision and delegation are important components of nurse-led care costs. More rigorous research involving a wider range of nurses from many countries is needed reporting detailed accounts of nurses’ roles and competencies, qualifications, training, resources, time available for consultations, and all-cause costs.
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The economic impact of nurse-led primary care remains less documented than its clinical quality.
“Nevertheless, the economic impact of nurse-led primary care remains less documented than its clinical quality.9,20,23,26,42-44”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [43]
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- Authors
- Martínez-González, N. A., Rosemann, T., Djalali, S., Huber-Geismann, F., & Tandjung, R.
- Affiliations
- University of Zurich (CH)
- Venue
- Medical Care Research and Review
- Publisher
- SAGE Publications
- Published
- 2015-05-12
- Volume
- 72
- Issue
- 4
- Pages
- 395-418
- ISSN
- 1077-5587 (ISSN-L)
- 1552-6801
- OpenAlex
- W2171264075
- Cited by
- 60
- References
- 54
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 5 · 2018: 2 · 2017: 10 · 2016: 2 · 2015: 2
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Care Research and Review (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- Academy of Medical Sciences
- Akademie der Naturwissenschaften
- Schweizerische Akademie der Medizinischen Wissenschaften
- 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 › Emergency Medical Services › Global Health Workforce Issues
- Keywords
- task shifting, nurse-led care, primary care, resource utilization (health care), consultation time, referral, drug prescribing, health care costs, nursing competencies
- MeSH terms
- Health Policy, Humans, Practice Patterns, Physicians', Primary Health Care, Randomized Controlled Trials as Topic, Delegation, Professional, Practice Patterns, Nurses'
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