Potential savings from the adoption of nurse practitioner technology in the Canadian health care system.

An investigation is reported of the potential for reducing aggregate medical costs by the introduction of nurse practitioners into the Canadian health care system to an extent consistent with demonstrated safety and effectiveness. A cost model is developed for this purpose and estimates of its parameters are provided. The cost model is coupled with a demographic projection model and potential cost reductions are simulated over the period 1980-2050, under alternative assumptions. Results suggest that savings could have been in the range 10-15% in 1980 for medical services as a whole, and 16-24% for ambulatory services. The estimated savings percentages are quite insensitive to projected changes in the age structure of the Canadian population.

[1]  Marilyn E. Manser,et al.  Scale Economies in the Delivery of Medical Care: A Mixed Integer Programming Analysis of Efficient Manpower Utilization , 1974 .

[2]  L. Linn.  Patient Acceptance of the Family Nurse Practitioner , 1976, Medical Care.

[3]  E. Wagner,et al.  Nurse practitioner and physician adherence to standing orders criteria for consultation or referral. , 1982, American journal of public health.

[4]  E. Skinner,et al.  Episode–Based Efficiency Comparisons for Physicians and Nurse Practitioners , 1982, Medical care.

[5]  U. Reinhardt,et al.  A Product Function for Physician Services , 1972 .

[6]  H C Sox,et al.  Quality of patient care by nurse practitioners and physician's assistants: a ten-year perspective. , 1979, Annals of internal medicine.

[7]  D. Sackett,et al.  The Burlington randomized trial of the nurse practitioner. , 1974, The New England journal of medicine.

[8]  C. Goldsmith,et al.  Nurse practitioners in primary care. 3. The southern Ontario randomized trial. , 1973, Canadian Medical Association journal.

[9]  W. Spitzer,et al.  Nurse practitioners in primary care iv. Impact of an interdisciplinary team on attitudes of a rural population. , 1975, Canadian Medical Association journal.

[10]  J. G. Fox,et al.  The Public's View of Physicians' Assistants and Nurse Practitioners: A Survey of Baltimore Urban Residents , 1979, Medical care.

[11]  D. Cherkin.  Factors Influencing the Physician Market for Primary Care New Health Practitioners , 1980, Medical care.

[12]  F. Denton,et al.  Population Aging and Future Health Costs in Canada , 1983 .

[13]  F L Golladay,et al.  Allied Health Manpower Strategies: Estimates of the Potential Gains from Efficient Task Delegation , 1973, Medical care.

[14]  L. Chambers,et al.  A Controlled Trial of the Impact of the Family Practice Nurse on Volume, Quality, and Cost of Rural Health Services , 1977, Medical care.

[15]  R. Zeckhauser,et al.  The Productivity Potential of the Physician Assistant , 1974 .

[16]  W. Spitzer,et al.  Nurse practitioners in primary care. VI. Assessment of their deployment with the Utilization and Financial Index. , 1976, Canadian Medical Association journal.

[17]  D. Rabin,et al.  Delegation Potential of Primary Care Visits by Physician Assistants, Medex and Primex , 1980, Medical care.

[18]  M. Fottler.  Physician Attitudes Toward Physician Extenders: A Comparison of Nurse Practitioners and Physician Assistants , 1979, Medical care.

[19]  D. Sackett,et al.  The Burlington randomized trial of the nurse practitioner: health outcomes of patients. , 1974, Annals of internal medicine.

[20]  K. M. Barker,et al.  The Use of Nurse Practitioners in a General Practice , 1974, Medical care.

[21]  R. Hoekelman.  What constitutes adequate well-baby care? , 1975, Pediatrics.

[22]  F. Denton,et al.  Some demographic consequences of changing cohort fertility patterns: An investigation using the Gompertz function. , 1974, Population studies.

[23]  F. Denton,et al.  Health-care costs when the population changes , 1975 .

[24]  Ken R. Smith,et al.  AN ANALYSIS OF THE OPTIMAL USE OF INPUTS IN THE PRODUCTION OF MEDICAL SERVICES , 1972 .

[25]  Acceptance of the nurse practitioner: attitudes of health care administrators. , 1976, Inquiry : a journal of medical care organization, provision and financing.

[26]  J. McKenzie,et al.  Physicians and nurse practitioners: do they provide equivalent health care? , 1982, American journal of public health.

[27]  U. Reinhardt.  Manpower substitution and productivity in medical practice: review of research. , 1973, Health services research.