Economic evaluation of nurse practitioners versus GPs in treating common conditions
Open accessAbstract
BACKGROUND: As studies evaluating substitution of care have revealed only limited evidence on cost-effectiveness, a trial was conducted to evaluate nurse practitioners as a first point of contact in Dutch general practices. AIM: To estimate costs of GP versus nurse practitioner consultations from practice and societal perspectives. DESIGN OF STUDY: An economic evaluation was conducted alongside a randomised controlled trial between May and October 2006, wherein 12 nurse practitioners and 50 GPs working in 15 general practices (study practices) participated. Consultations by study practices were also compared with an external reference group, with 17 GPs working in five general practices without the involvement of nurse practitioners. METHOD: Direct costs within the healthcare sector included resource use, follow-up consultations, length of consultations, and salary costs. Costs outside the healthcare sector were productivity losses. Sensitivity analyses were performed. RESULTS: Direct costs were lower for nurse practitioner consultations than for GP consultations at study practices. This was also the case for direct costs plus costs from a societal perspective for patients aged <65 years. Direct costs of consultations at study practices were lower than those of reference practices, while practices did not differ for direct costs plus costs from a societal perspective for patients aged <65 years. Cost differences are mainly caused by the differences in salary. CONCLUSION: By involving nurse practitioners, substantial economic 'savings' could be used for redesigning primary care, to optimise the best skill mix, and to cover the full range of primary care activities.
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The literature generally reports similar or marginally lower costs for nurse-led services.
“This literature generally reports similar27,34-37 or marginally lower29,38-41 costs for nurse-led services.”
From Evaluating the cost of NP-led vs. GP-led primary care in British Columbia (2024) · cites this paper as [38]
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- Authors
- Dierick-van Daele, A. T., Steuten, L. M., Metsemakers, J. F., Derckx, E. W., Spreeuwenberg, C., & Vrijhoef, H. J.
- Affiliations
- Maastricht University Medical Centre (NL)
- Venue
- British Journal of General Practice
- Published
- 2010-01-01
- Volume
- 60
- Issue
- 570
- Pages
- e28-e35
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC2801803
- OpenAlex
- W2008948279
- Cited by
- 62
- References
- 24
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 10 · 2014: 8 · 2013: 3 · 2012: 3
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Twente Research Information (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- University of Twente Research Information (submittedVersion)
- Funders
- Ministerie van Volksgezondheid, Welzijn en Sport
- 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
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- nurse practitioners, general practitioners, cost-effectiveness, primary care, consultation costs, social costs, productivity loss, personnel costs, skill mix, first point of contact, common conditions, elderly patients
- MeSH terms
- Adult, Aged, Cost-Benefit Analysis, Family Practice, Female, Humans, Male, Middle Aged, Nurse Practitioners, Drug Prescriptions, Referral and Consultation, Salaries and Fringe Benefits
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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