Shifting care from doctors to nurses is one way of meeting the demand caused by ageing populations, rising expectations and reforms that move care from hospitals to primary care. While patient satisfaction can increase, the change may not always save money.
While demands for health care rise, there are limits on the number of physicians and on the finance to pay for them. Consequently managers are looking to reduce the burden on doctors by making more use of nurses within primary care.
By studying 25 articles that related to 16 studies, the Cochrane Review Authors found that nurses had taken over a variety of roles in different parts of the world. They concluded that replacing doctors with nurses led to similar health outcomes and higher levels of satisfaction for the patient.
In some studies, however, there was clear evidence that nurses tended to spend longer with the patients, gave more information and recall patients more frequently than did doctors. This suggests that while the cost of training and employing nurses is less than for doctors, the overall cost of providing care remains about the same.
“We concluded that appropriately trained nurses can produce as high quality care as primary care doctors and may achieve as good health outcomes for patients, but may not reduce cost or physician workload” says Miranda Laurant, the review lead author, who works in the Centre for Quality Care of Research at the Radboud University Nijmegen, The Netherlands.