Evidence map›Paper›PMID 32791993›Full record

ArticleBMC family practice2020

Differences in patient population and service provision between nurse practitioner and general practitioner consultations in Swiss primary care: a case study.

Stefan Gysin, Rahel Meier, Anneke van Vught, Christoph Merlo, Armin Gemperli, Stefan Essig

Abstract read
In one paragraph

Article in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Stefan GysinInstitute of Primary and Community Care, Schwanenplatz 7, 6004, Luzern, Switzerland. stefan.gysin@iham-cc.ch.ORCID 0000-0002-6344-6873
Rahel MeierInstitute of Primary Care Zurich, University of Zurich and University Hospital Zurich, Zürich, Switzerland.
Anneke van VughtHAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands.
Christoph MerloInstitute of Primary and Community Care, Schwanenplatz 7, 6004, Luzern, Switzerland.
Armin GemperliDepartment of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland.
Stefan EssigInstitute of Primary and Community Care, Schwanenplatz 7, 6004, Luzern, Switzerland.

Funding

CSS Insurance n.a.Health Department of the Canton of Uri n.a.
6 · The paper itself

Abstract

backgroundPrimary care systems around the world have implemented nurse practitioners (NPs) to ensure access to high quality care in times of general practitioner (GP) shortages and changing health care needs of a multimorbid, ageing population. In Switzerland, NPs are currently being introduced, and their exact role is yet to be determined. The aim of this study was to get insight into patient characteristics and services provided in NP consultations compared to GP consultations in Swiss primary care.

methodsThis case study used retrospective observational data from electronic medical records of a family practice with one NP and two GPs. Data on patient-provider encounters were collected between August 2017 and December 2018. We used logistic regression to assess associations between the assignment of the patients to the NP or GP and patient characteristics and delivered services respectively.

resultsData from 5210 patients participating in 27,811 consultations were analyzed. The average patient age was 44.3 years (SD 22.6), 47.1% of the patients were female and 19.4% multimorbid. 1613 (5.8%) consultations were with the NP, and 26,198 (94.2%) with the two GPs. Patients in NP consultations were more often aged 85+ (OR 3.43; 95%-CI 2.70-4.36), multimorbid (OR 1.37; 95%-CI 1.24-1.51; p < 0.001) and polypharmaceutical (OR 1.28; 95%-CI 1.15-1.42; p < 0.001) in comparison to GP consultations. In NP consultations, vital signs (OR 3.05; 95%-CI 2.72-3.42; p < 0.001) and anthropometric data (OR 1.33; 95%-CI 1.09-1.63; p 0.005) were measured more frequently, and lab tests (OR 1.16; 95%-CI 1.04-1.30; p 0.008) were ordered more often compared to GP consultations, independent of patient characteristics. By contrast, medications (OR 0.35; 95%-CI 0.30-0.41; p < 0.001) were prescribed or changed less frequently in NP consultations.

conclusionsQuantitative data from pilot projects provide valuable insights into NP tasks and activities in Swiss primary care. Our results provide first indications that NPs might have a focus on and could offer care to the growing number of multimorbid, polypharmaceutical elderly in Swiss primary care.

Indexed as

General PractitionersNurse PractitionersAgedFemaleHumansPrimary Health CareReferral and ConsultationRetrospective StudiesSwitzerlandAdvanced nursing practiceAdvanced practice nurseElderlyFamily practiceGeneral practitionerMultimorbidityNurse practitionerPolypharmacyPrimary care

Identifiers

PMID32791993
PMCPMC7425147

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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.