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Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience
OBJECTIVE: This study aims to evaluate the impact of a primary care nurse practitioner (NP)-led clinic model piloted in British Columbia (Canada) on patients’ health and care experience. DESIGN: The study relies on a quasi-experimental longitudinal design based on a pre-and-post survey of patients r...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603457/ https://www.ncbi.nlm.nih.gov/pubmed/37857545 http://dx.doi.org/10.1136/bmjopen-2023-072812 |
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author | Contandriopoulos, Damien Bertoni, Katherine Duhoux, Arnaud Randhawa, Gurprit K |
author_facet | Contandriopoulos, Damien Bertoni, Katherine Duhoux, Arnaud Randhawa, Gurprit K |
author_sort | Contandriopoulos, Damien |
collection | PubMed |
description | OBJECTIVE: This study aims to evaluate the impact of a primary care nurse practitioner (NP)-led clinic model piloted in British Columbia (Canada) on patients’ health and care experience. DESIGN: The study relies on a quasi-experimental longitudinal design based on a pre-and-post survey of patients receiving care in NP-led clinics. The prerostering survey (T0) was focused on patients’ health status and care experiences preceding being rostered to the NP clinic. One year later, patients were asked to complete a similar survey (T1) focused on the care experiences with the NP clinic. SETTING: To solve recurring problems related to poor primary care accessibility, British Columbia opened four pilot NP-led clinics in 2020. Each clinic has the equivalent of approximately six full-time NPs, four other clinicians plus support staff. Clinics are located in four cities ranging from urban to suburban. PARTICIPANTS: Recruitment was conducted by the clinic’s clerical staff or by their care provider. A total of 437 usable T0 surveys and 254 matched and usable T1 surveys were collected. PRIMARY OUTCOME MEASURES: The survey instrument was focused on five core dimensions of patients’ primary care experience (accessibility, continuity, comprehensiveness, responsiveness and outcomes of care) as well as on the SF-12 Short-form Health Survey. RESULTS: Scores for all dimensions of patients’ primary care experience increased significantly: accessibility (T0=5.9, T1=7.9, p<0.001), continuity (T0=5.5, T1=8.8, p<0.001), comprehensiveness (T0=5.6, T1=8.4, p<0.001), responsiveness (T0=7.2, T1=9.5, p<0.001), outcomes of care (T0=5.0, T1=8.3, p<0.001). SF-12 Physical health T-scores also rose significantly (T0=44.8, T1=47.6, p<0.001) but no changes we found in the mental health T scores (T0=45.8, T1=46.3 p=0.709). CONCLUSIONS: Our results suggest that the NP-led primary care model studied here likely constitutes an effective approach to improve primary care accessibility and quality. |
format | Online Article Text |
id | pubmed-10603457 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-106034572023-10-28 Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience Contandriopoulos, Damien Bertoni, Katherine Duhoux, Arnaud Randhawa, Gurprit K BMJ Open General practice / Family practice OBJECTIVE: This study aims to evaluate the impact of a primary care nurse practitioner (NP)-led clinic model piloted in British Columbia (Canada) on patients’ health and care experience. DESIGN: The study relies on a quasi-experimental longitudinal design based on a pre-and-post survey of patients receiving care in NP-led clinics. The prerostering survey (T0) was focused on patients’ health status and care experiences preceding being rostered to the NP clinic. One year later, patients were asked to complete a similar survey (T1) focused on the care experiences with the NP clinic. SETTING: To solve recurring problems related to poor primary care accessibility, British Columbia opened four pilot NP-led clinics in 2020. Each clinic has the equivalent of approximately six full-time NPs, four other clinicians plus support staff. Clinics are located in four cities ranging from urban to suburban. PARTICIPANTS: Recruitment was conducted by the clinic’s clerical staff or by their care provider. A total of 437 usable T0 surveys and 254 matched and usable T1 surveys were collected. PRIMARY OUTCOME MEASURES: The survey instrument was focused on five core dimensions of patients’ primary care experience (accessibility, continuity, comprehensiveness, responsiveness and outcomes of care) as well as on the SF-12 Short-form Health Survey. RESULTS: Scores for all dimensions of patients’ primary care experience increased significantly: accessibility (T0=5.9, T1=7.9, p<0.001), continuity (T0=5.5, T1=8.8, p<0.001), comprehensiveness (T0=5.6, T1=8.4, p<0.001), responsiveness (T0=7.2, T1=9.5, p<0.001), outcomes of care (T0=5.0, T1=8.3, p<0.001). SF-12 Physical health T-scores also rose significantly (T0=44.8, T1=47.6, p<0.001) but no changes we found in the mental health T scores (T0=45.8, T1=46.3 p=0.709). CONCLUSIONS: Our results suggest that the NP-led primary care model studied here likely constitutes an effective approach to improve primary care accessibility and quality. BMJ Publishing Group 2023-10-18 /pmc/articles/PMC10603457/ /pubmed/37857545 http://dx.doi.org/10.1136/bmjopen-2023-072812 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | General practice / Family practice Contandriopoulos, Damien Bertoni, Katherine Duhoux, Arnaud Randhawa, Gurprit K Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title | Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title_full | Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title_fullStr | Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title_full_unstemmed | Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title_short | Pre–post analysis of the impact of British Columbia nurse practitioner primary care clinics on patient health and care experience |
title_sort | pre–post analysis of the impact of british columbia nurse practitioner primary care clinics on patient health and care experience |
topic | General practice / Family practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603457/ https://www.ncbi.nlm.nih.gov/pubmed/37857545 http://dx.doi.org/10.1136/bmjopen-2023-072812 |
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