Nurse practitioner–physician comanagement of primary care patients: The promise of a new delivery care model to improve quality of care

Background: The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)–physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP–physician comanagement in primary care. Purpose: This is the first review to synthesize all available studies that compare the effects of NP–physician comanagement to an individual physician managing primary care. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) framework guided the conduct of this systematic review. Five electronic databases were searched. Titles, abstracts, and full texts were reviewed, and inclusion/exclusion criteria were applied to narrow search results to eligible studies. Quality appraisal was performed using Downs and Black’s quality checklist for randomized and nonrandomized studies. Results: Six studies were identified for synthesis. Three outcome categories emerged: (a) primary care provider adherence to recommended care guidelines, (b) empirical changes in clinical patient outcomes, and (c) patient/caregiver quality of life. Significantly more recommended care guidelines were completed with NP–physician comanagement. There was variability of clinical patient outcomes with some findings favoring the comanagement model. ...
Source: Health Care Management Review - Category: American Health Tags: Features Source Type: research