ArticleBMJ open2017
Towards an optimal composition of general practitioners and nurse practitioners in out-of-hours primary care teams: a quasi-experimental study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02407847 (The), which is not on this map. Cited by 10 papers, 1 of them a synthesis 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.
The (Cost-)Effectiveness of Substitution in Out-of-hours Primary Care; Towards an Optimal Balance Between General Practitioners and Nurse Practitioners.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Task shifting from general practitioners to other health professionals in out-of-hours primary care - a systematic literature review on content and quality of task shifting.The European journal of general practice · 2024Pooled it
- Task shifting from general practitioners to nurses and the association with patient flow and resource use in out-of-hours primary care clinics: a descriptive register-based study.Scandinavian journal of primary health care · 2026Article
- Interprofessional teams and capacity in collaborative primary care: a rapid scoping review.Systematic reviews · 2026Article
- Task shifting from general practitioners to nurses in out-of-hours primary care: an explorative case study of team-based practices.Scandinavian journal of primary health care · 2025Article
- Investigating Weekend Effect in the Management of Upper and Lower Extremity Degloving Injuries.Plastic and reconstructive surgery. Global open · 2023Article
- Staff views of a hospital at home model implemented in a Scottish care setting.AIMS public health · 2021Article
- [Skill mix of nurses and primary health care professionals: a systematic review].Revista panamericana de salud publica = Pan American journal of public health · 2020Review
- Factors affecting medical file documentation during telephone triage at an emergency call centre: a cross-sectional study of out-of-hours home visits by general practitioners in France.BMC health services research · 2019Article
- Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units.BMJ open · 2018Article
- Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study.BMC health services research · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo gain insights into the ability of general practitioners (GPs) and nurse practitioners (NPs) to meet patient demands in out-of-hours primary care by comparing the outcomes of teams with different ratios of practitioners.
designQuasi-experimental study.
settingA GP cooperative (GPC) in the Netherlands.
interventionTeam 2 (1 NP, 3 GPs) and team 3 (2 NPs, 2 GPs) were compared with team 1 (4 GPs). Each team covered 35 weekend days.
participantsAll 9503 patients who were scheduled for a consultation at the GPC through a nurse triage system. OUTCOME MEASURES: The primary outcome was the total number of consultations per provider for weekend cover between 10:00 and 18:00 hours. Secondary outcomes concerned the numbers of patients outside the NPs' scope of practice, patient safety, resource use, direct healthcare costs and GPs' performance.
resultsThe mean number of consultations per shift was lower in teams with NPs (team 1: 93.9, team 3: 87.1; p<0.001). The mean proportion of patients outside NPs' scope of practice per hour was 9.0% (SD 6.7), and the highest value in any hour was 40%. The proportion of patients who did not receive treatment within the targeted time period was higher in teams with NPs (team 2, 5.2%; team 3, 8.3%) compared with GPs only (team 1 3.5%) (p<0.01). Team 3 referred more patients to the emergency department (14.7%) compared with team 1 (12.0%; p=0.028). In teams with NPs, GPs more often treated urgent patients (team 1: 13.2%, team 2: 16.3%, team 3: 21.4%; p<0.01) and patients with digestive complaints (team 1: 11.1%, team 2: 11.8%, team 3: 16.7%; p<0.01).
conclusionsPrimary healthcare teams with a ratio of up to two GPs and two NPs provided sufficient capacity to provide care to all patients during weekend cover. Areas of concern are the number of consultations, delay in patient care and referrals to the emergency department.
trial registrationNCT02407847.
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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.