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Do practice nurse solve future GP capacity problems?
Lamkaddem, M., Haan, J. de, Bakker, D. de. Do practice nurse solve future GP capacity problems? European Journal of Public Health: 2003, 13(4 sup) 97. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background: Task delegation is viewed as an important policy instrument to counter foreseen future shortages in GP capacity in the Netherlands. Therefore, a national programme to introduce practice nurses in general practice was launched in 1998 by the National Association of General Practice. In 2001 more than one third of general practices in the Netherlands had a practice nurse for on average 8 hours per week per fulltime working GP. Main task of these practice nurses is providing checkups of diabetes patients and COPD patients. Empirical evidence whether the introduction of practice nurses effectively reduced GP workload and therefore contributed to solving future capacity problems fails up to now. Aim: To provide empirical evidence whether the introduction of practice nurses reduced GP’s workload in terms of number of consultations. Methods: Data are analyzed for the period 1999 to 2002 of the National Information Network in General Practice (LINH) a computerized medical record registration network of more than 100 practices. Consultations of GP’s, practice assistants and practice nurses are registered on a continuous basis in this network. Diagnosis is available from 2001 onwards. Consultation frequencies of GP’s, practice assistants and practice nurses are compared one year before and one year after introduction of the practice nurse. Further comparison with practices without practice nurses took place. Results: The number of consultations of practice nurses is small compared to GP and practice assistant consultations: on average less than 2%. The consultation rate of general practitioners and practice assistants did not change significantly. Conclusions: The introduction of practice nurses will not deliver a significant solution to future GP capacity problems. Important reason for this is that the tasks of practice nurses are limited to diabetes and COPD care. Other research shows that this led to gains in quality of care: checkups take place more consistently and patients are informed better. Further delegation of tasks is necessary to reduce GP workload significantly. (aut. ref.)
Background: Task delegation is viewed as an important policy instrument to counter foreseen future shortages in GP capacity in the Netherlands. Therefore, a national programme to introduce practice nurses in general practice was launched in 1998 by the National Association of General Practice. In 2001 more than one third of general practices in the Netherlands had a practice nurse for on average 8 hours per week per fulltime working GP. Main task of these practice nurses is providing checkups of diabetes patients and COPD patients. Empirical evidence whether the introduction of practice nurses effectively reduced GP workload and therefore contributed to solving future capacity problems fails up to now. Aim: To provide empirical evidence whether the introduction of practice nurses reduced GP’s workload in terms of number of consultations. Methods: Data are analyzed for the period 1999 to 2002 of the National Information Network in General Practice (LINH) a computerized medical record registration network of more than 100 practices. Consultations of GP’s, practice assistants and practice nurses are registered on a continuous basis in this network. Diagnosis is available from 2001 onwards. Consultation frequencies of GP’s, practice assistants and practice nurses are compared one year before and one year after introduction of the practice nurse. Further comparison with practices without practice nurses took place. Results: The number of consultations of practice nurses is small compared to GP and practice assistant consultations: on average less than 2%. The consultation rate of general practitioners and practice assistants did not change significantly. Conclusions: The introduction of practice nurses will not deliver a significant solution to future GP capacity problems. Important reason for this is that the tasks of practice nurses are limited to diabetes and COPD care. Other research shows that this led to gains in quality of care: checkups take place more consistently and patients are informed better. Further delegation of tasks is necessary to reduce GP workload significantly. (aut. ref.)
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