SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2006
Comparing the cost of nurse practitioners and GPs in primary care: modelling economic data from randomised trials.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01388374 (A Study on the), which is not on this map. Cited by 27 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Study on the (Cost-)Effectiveness of Nurse Practitioners Working at the Primary Out of Hours Emergency Service and the Feasibility of Implementing These Nurses
Who cites it
27 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2019Pooled it
- Nurses as substitutes for doctors in primary care.The Cochrane database of systematic reviews · 2018Pooled it
- Cost-effectiveness of nurse practitioners in primary and specialised ambulatory care: systematic review.BMJ open · 2015Pooled it
- Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy.The Cochrane database of systematic reviews · 2014Pooled it
- Substitution of physicians by nurses in primary care: a systematic review and meta-analysis.BMC health services research · 2014Pooled it
- The breadth of primary care: a systematic literature review of its core dimensions.BMC health services research · 2010Pooled it
- The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study.BMC family practice · 2016Trial
- Economic evaluation of nurse practitioners versus GPs in treating common conditions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Trial
- An innovative nurse practitioner-led service for children from families living in housing instability.Primary health care research & development · 2025Article
- Evaluating the cost of NP-led vs. GP-led primary care in British Columbia.Healthcare management forum · 2024Article
- Patterns of GP and nurse independent prescriber prescriptions for antibiotics dispensed in the community in England: a retrospective analysis.The Journal of antimicrobial chemotherapy · 2023Article
- Perspectives of pharmacists in general practice from qualitative focus groups with patients during a pilot study.BJGP open · 2022Article
- Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes.International journal of environmental research and public health · 2021Review
- The Impact of Digital-First Consultations on Workload in General Practice: Modeling Study.Journal of medical Internet research · 2020Article
- Outcomes of primary care delivery by nurse practitioners: Utilization, cost, and quality of care.Health services research · 2020Article
- [Implementation of nurse demand managment in primary health care service providers in Catalonia].Atencion primaria · 2017Article
- Article
- [Evaluation of Nurse Demand Management in Primary Care].Atencion primaria · 2016Article
- Article
- Research into practice: accessing primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Review
Corrections and comments
- Commented on byComparing costs.2006
- Commented on by
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of nurse practitioners in primary care has recently expanded. While there are some outcome data available for different types of consultations, little is known about the relative cost.
aimTo compare the cost of primary care provided by nurse practitioners with that of salaried GPs. DESIGN OF STUDY: Synthesis, modelling, and analysis of published data from the perspective of general practices and the NHS. DATA SOURCES: Two published randomised controlled trials.
methodA dataset of resource use for a simulated group of patients in a typical consultation was modelled. Current unit costs were used to obtain a consensus mean cost per consultation.
resultsMean cost of a nurse practitioner consultation was estimated at 9.46 UK pounds (95% confidence interval [CI] = 9.16 to 9.75 pounds) and for a GP was 9.30 UK pounds (95% CI = 9.04 to 9.56 pounds) according to salary and overheads, that is, from the perspective of general practices. From the NHS perspective, which included training costs, the estimated mean costs were 30.35 UK pounds (95% CI = 27.10 to 33.59 pounds) and 28.14 UK pounds (95% CI = 25.43 to 30.84 pounds) respectively. Sensitivity analysis suggested that the time spent by GPs contributing to nurse practitioners' consultations (including return visits) was an important factor in increasing costs associated with nurse practitioners.
conclusionEmploying a nurse practitioner in primary care is likely to cost much the same as employing a salaried GP according to currently available data. There is considerable variability of qualifications and experience of nurse practitioners, which suggests that skill-mix decisions should depend on the full range of roles and responsibilities rather than cost.
Indexed as
Identifiers
16834880PMC1872064What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.