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Return to table of contentsLiterature and resourcesA comparison of resource utilization in nursepractitioners and physicians.Hemani A, Rastegar DA, Hill C, et al.Eff Clin Pract. 1999 Nov–Dec;2(6):258–265.University of Maryland Division of General InternalMedicine, BaltimoreCONTEXT: Nurse practitioners increasingly provideprimary care in a variety of settings. Little is knownabout how resource utilization for patients assignedto nurse practitioners compares with that for patientsassigned to physicians. OBJECTIVE: To compare healthcare resource utilization for adult patients assigned toa nurse practitioner with that for patients assigned toa resident or attending physician. DESIGN: Prospective,quasi-randomized study. SETTING: Primary careclinic at a Veterans Affairs medical center. PATIENTS:450 new primary care patients: 150 were assigned to anurse practitioner, 150 to a resident physician, and 150to an attending physician. OUTCOME MEASURES:We collected data on laboratory and radiologic testing,specialty care, primary care, emergency or walk-in visits,and hospitalizations over a 1-year period. We also collectedinformation on baseline chronic illnesses, bloodpressure, and weight. RESULTS: Resource utilizationfor patients assigned to a nurse practitioner was higherthan that for patients assigned to a resident in 14 of 17utilization measures (3 were statistically significant)and higher in 10 of 17 measures when compared withpatients assigned to an attending physician (3 werestatistically significant). None of the utilization measuresfor patients in the nurse practitioner group was significantlylower than those for either physician group.CONCLUSIONS: In a primary care setting, nursepractitioners may utilize more health care resourcesthan physicians. PMID: 10788023 [PubMed - indexedfor MEDLINE]How well are nurse practitioners prepared for practice:Results of a 2004 questionnaire study.Hart AM, Macnee CL.J Am Acad Nurse Pract. 2007 Jan;19(1):35–42.University of Wyoming Fay W. Whitney Schoolof Nursing, Laramie, Wyo.PURPOSE: The purpose of this study was to evaluatethe perceived preparedness of nurse practitioners (NPs)for practice after completing their basic NP educationalprograms and to evaluate NPs’ perceived preparednessin and their perceived importance of select clinical contentareas basic to NP education. DATA SOURCES:This cross-sectional descriptive study used a writtenquestionnaire consisting of 32 items, two of which contained25 sub-items. Subjects were asked to rate theiroverall level of preparedness when they completedtheir NP program and both their level of preparationin and the importance of 25 clinical content areas. Thequestionnaires were administered to attendees at twolarge national NP conferences in 2004; a total of 562questionnaires were completed and used in the analysis.CONCLUSIONS: Ten percent of the sample perceivedthat they were very well prepared for practice as an NPafter completing their basic NP education. Fifty-onepercent perceived that they were only somewhat orminimally prepared. Current age, years since graduationfrom an NP program, and age when attending theNP program did not differ significantly for those whofelt prepared versus those who did not. For a number ofcontent areas, subjects did not perceive that they werewell prepared in the same areas that they perceivedwere very important. IMPLICATIONS FOR PRAC-TICE: Our results indicate that formal NP educationis not preparing new NPs to feel ready for practice andsuggests several areas where NP educational programsneed to be strengthened. Practicing NPs are the basis ofthe NP profession, and their views need to be sought,listened to, and reflected upon as we advance towardexpanded preparation at the doctoral level. PMID:17214866 [PubMed - indexed for MEDLINE]Attitudes toward nurse practitioner-led chronic diseasemanagement to improve outpatient quality of care.Sciamanna CN, Alvarez K, Miller J, et al.Am J Med Qual. 2006 Nov–Dec;21(6):375–381.Jefferson Medical College Department of Health Policy,PhiladelphiaTo understand the acceptability for a model of chronicdisease management, in which primary care patients seenurse practitioners for structured visits using an evidencebasedencounter form, the authors sent a mailed surveyto primary care physicians and nurse practitioners. Atotal of 212 subjects completed the survey, for a totalresponse rate of 53% (physicians, 44%; nurse practitioners,61%). Most physicians (79.5%) reported thatnurse practitioners saw patients in their practice. Mostphysicians (80.0%) and nurse practitioners (95.7%)believed that the proposed model of care would improvethe control of chronic illnesses. In addition, mostphysicians (73.8%) and nurse practitioners (87.6%)believed that the model of care would be of interest tosimilar providers. Overall, the high level of support forScope of Practice Data Series: Nurse practitioners • Appendix64