Biomaterial Database

Nurse practitioners and physician assistants as primary care providers in institutional settings. 1998

P D Jacobson, and L E Parker, and I D Coulter

Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA.

This paper describes the scope of primary care practice and autonomy of nurse practitioners (NPs) and physician assistants (PAs) at nine health maintenance organizations (HMOs) and multispecialty clinics (MSCs). We found that the larger an institution's managed care population, the greater the NPs' and PAs' scope of practice and autonomy, although patients with complex illnesses or multisystem problems usually were referred directly to a physician. Alternative policies to increase the number of primary care physicians might slow the growth in hiring new NPs and PAs, but are unlikely to reduce their primary care role in managed care settings. Further research is needed to consider whether these results are applicable to a broader range of practice settings.

UI	MeSH Term	Description	Entries
D007325	Institutional Practice	Professional practice as an employee or contractee of a health care institution.	Institutional Practices,Practice, Institutional,Practices, Institutional
D007407	Interviews as Topic	Works about conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes works about school admission or job interviews.	Group Interviews,Interviewers,Interviews, Telephone,Oral History as Topic,Group Interview,Interview, Group,Interview, Telephone,Interviewer,Interviews, Group,Telephone Interview,Telephone Interviews
D007587	Job Description	Statement of the position requirements, qualifications for the position, wage range, and any special conditions expected of the employee.	Position Description,Description, Job,Description, Position,Descriptions, Job,Descriptions, Position,Job Descriptions,Position Descriptions
D009626	Terminology as Topic	Works about the terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.	Etymology,Nomenclature as Topic,Etymologies
D009722	Nurse Practitioners	Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.	Nurse Practitioner,Practitioner, Nurse,Practitioners, Nurse
D010823	Physician Assistants	Health professionals who practice medicine as members of a team with their supervising physicians. They deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. Duties may include physical exams, diagnosis and treatment of disease, interpretation of tests, assist in surgery, and prescribe medications. (from http://www.aapa.orglabout-pas accessed 2114/2011)	Doctor's Assistant,Feldsher,Feldshers,Physician Assistant,Physicians' Assistants,Physicians' Extender,Physicians' Extenders,Doctor's Assistants,Assistant, Doctor's,Assistant, Physicians',Assistants, Doctor's,Assistants, Physician,Assistants, Physicians',Doctor Assistant,Doctor Assistants,Doctors Assistant,Extender, Physicians',Extenders, Physicians',Physician Extender,Physician Extenders,Physician's Assistants,Physician's Extender,Physician's Extenders,Physicians Assistants,Physicians Extender,Physicians' Assistant
D011320	Primary Health Care	Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)	Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D011787	Quality of Health Care	The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.	Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D003365	Costs and Cost Analysis	Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.	Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D006279	Health Maintenance Organizations	Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)	Group Health Organizations, Prepaid,HMO,Prepaid Group Health Organizations,Health Maintenance Organization,Organizations, Health Maintenance,Organization, Health Maintenance