" The findings may be considered controversial by health care professionals and policymakers, as there is a widely held belief that nurses can save physicians' time and reduce costs," says lead reviewer Miranda Laurant of Radboud University, Nijmegen in the Netherlands.

Demand for primary care services has increased in many countries due to aging populations, rising patient expectations and changing health-care approaches. At the same time, availability of general practitioners may be limited, and there is increasing pressure to contain costs. Shifting care from physicians to nurses is one possible response to these challenges.

According to the American Nurses Association, "Some 60 to 80 percent of primary and preventive care traditionally done by doctors can be done by a nurse for less money." The evidence, however, shows that nurses' lower salaries do not necessarily equate to lower overall costs. The ANA advocates for removing regulatory and legislative barriers to increased use of nurses as health care providers.

The systematic review included 16 studies totaling more than 25,000 patients in the United Kingdom, United States and Canada.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

In each study, nurses were responsible for one of the following types of care: first contact and ongoing care for general patients; routine management of patients with chronic conditions; or first contact care for patients se
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Contact: Miranda Laurant
M.Laurant@kwazo.umcn.nl
Center for the Advancement of Health
27-Apr-2005