tailieunhanh - Báo cáo y học: "Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians"

Nghiên cứu bối cảnh đã cho thấy rằng chất lượng chăm sóc sức khỏe ban đầu cung cấp bởi các học viên y tá là bằng với các bác sĩ. Tuy nhiên, những nghiên cứu này không đo lường thực hành học viên y tá đã cùng một mức độ độc lập như là thực hành bác sĩ so sánh, cũng không nghiên cứu trước đây cung cấp so sánh trực tiếp các kết quả cho bệnh nhân với nhà cung cấp dịch vụ hành nghề y tá hoặc bác sĩ. Mục tiêu Để so sánh kết quả cho bệnh. | ORIGINAL CONTRIBUTION Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians A Randomized Trial Mary O. Mundinger DrPH Robert L. Kane MD Elizabeth R. Lenz PhD Annette M. Totten MPA Wei-Yann Tsai PhD Paul D. Cleary PhD William T. Friedewald MD Albert L. Siu MD MSPH__ Michael L. Shelanski MD PhD The many pressures on the us health care system and greater focus on health promotion and prevention have prompted debates about primary care workforce needs and the roles of various types of health care professionals. As nurse practitioners seek to define their niche in this environment questions are often raised about their effectiveness and appropriate scope of practice. several studies conducted during the last 2 decades1-4 suggest the quality of primary care delivered by nurse practitioners is equal to that of physicians. However these earlier studies did not directly compare nurse practitioners and physicians in primary care practices that were similar both in terms of responsibilities and patient panels. over time payment policies and state nurse practice acts that constrained the roles of nurse practitioners have changed. In more than half the states nurse practitioners now practice with- Context Studies have suggested that the quality of primary care delivered by nurse practitioners is equal to that of physicians. However these studies did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers. Objective To compare outcomes for patients randomly assigned to nurse practitioners or physicians for primary care follow-up and ongoing care after an emergency department or urgent care visit. Design Randomized trial conducted between August 1995 and October 1997 with patient interviews at 6 months after initial appointment and health services utilization