RT Journal Article
SR Electronic
T1 Economic evaluation of nurse practitioners versus GPs in treating common conditions
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e28
OP e35
DO 10.3399/bjgp10X482077
VO 60
IS 570
A1 Angelique TM Dierick-van Daele
A1 Lotte MG Steuten
A1 Job FM Metsemakers
A1 Emmy WCC Derckx
A1 Cor Spreeuwenberg
A1 Hubertus JM Vrijhoef
YR 2010
UL http://bjgp.org/content/60/570/e28.abstract
AB 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.