Table 4 Analysis of included studies with regard to complexity
Source | Patient Population | Setting | Professionals | NP role |
|---|---|---|---|---|
Qualitative study design | ||||
O’Brien et al. 2008, US | unspecific | unspecific | medical doctors & advanced practice nurses | NP is supervised and mentored by doctor |
Parker et al. [24], AU | unspecific | unspecific: primary health care | GP & NP | Collaborator with GP in primary health care |
O’Malley et al. [25], US | unspecific | PCMH | administrative staff, LPN, MA, NCM, NP, PA, physician, practice manager primary care experts, RN | Varies depending on practice, some are lead clinicians while others share care with physician |
Van der Biezen et al. [26], NL | unspecific | unspecific: general practices, GPC | GP, managers, NP/PA | Substitute and supplement in general practice and substitute in out-of-hours care in GPC (Substitute and Supplement) |
Lovink et al. [27], NL | older adults | unspecific: general practice & community | RN, NP & GP | Independent care providers, shared responsibility with GP, part of multidisciplinary team |
Boman et al. [28], NO/FI | older adults | unspecific: primary health care | GP, NP & nurse | Autonomous role within scope of practice and linking role between nurses and physicians; patient and health services; and to evidence-based practice. |
Côté et al. [29], CA | unspecific | unspecific: primary health care | GP & NP | Part of multidisciplinary primary care teams |
Pelletier et al. [30], CA | unspecific | unspecific: primary health care | GP, RN & NP | Part of primary health care team |
Quantitative study designs | ||||
Ohman-Strickland et al. [31], US | diabetics | unspecific: family medicine practices | NP/PA & physician | Staff member |
Everett et al. [32], US | unspecific | unspecific: outpatient practices | doctor & NP/PA | Primary care provider substitute to underserved patients with a range of disease severity |
Subramanian et al. [33], US | diabetics | VHA | NP/PA & physician | Independent primary care provider |
Yarnall et al. [34], US | unspecific theoretical panel | unspecific: ambulatory medical practices | NP/PA & physician | Member of primary care team |
Chung et al. [35], US | unspecific | unspecific: GP practice | NP/PA & PCP | Part of medical practice |
Mian et al. [36], CA | unspecific | CHC, family health teams, family practice units | FP, mental health worker, NP/PHCNP, social worker | FP and NP have interdependent roles in which NP is responsible for less complex care |
Morgan et al. [37], US | unspecific | VHA | NP/PA & physician | Primary care provider |
Donelan et al. [38], US | unspecific | unspecific: primary care practices | NP & physician | Practices with NPs describe them as a member of a collaborative pracitce. |
Everett et al. [39], US | medicare diabetics | unspecific: various practices | NP/PA & physician | Supplement provider and usual provider (Substitute) |
Everett et al. [40], US | medicare diabetics | unspecific: various practices | NP/PA & physician | Supplement provider and usual provider (Substitute) |
Dahrouge et al. [41], CA | unspecific | CHC | FP & NP | Consultative care, in which they NPs are substitutes; or shared care, in which NPs are supplements(Substitute and Supplement) |
Ku et al. [42], US | unspecific | CHC | lab staff, MA, NP/PA, physician, radiology staff | Member of staff with full, partial or restricted legal scope of practice |
Kuo et al. [43], US | diabetics | unspecific: primary care in communities | NP & PCP | Care provider |
Park [44], US | unspecific | PCMH and non-PCMH | NP/PA & physician | Complemental care provider |
Reckrey et al. [45], USA | homebound | home-based primary care | administrative assistant, NP, physician, RN, social worker | Team member with flexible role |
chronically ill | unspecific: primary care group practices | NP/PA & PCP | Primary care provider | |
Raji et al. [48], US | medicare, chronically ill | unspecific: various practices | MD & NP | Independent primary care provider |
Van der Biezen et al. [49], NL | unspecific | unspecific: GPC | GP & NP | Substitute in out-of-hours care |
D’Afflitti et al. [50], US | unspecific | unspecific: general internal medicine practice | GP & NP | GP and NP teams co-managing medically complex patients |
Yang et al. [51], US | diabetics | VHA | GP, PA & NP | Primary care provider |
Morgan et al. [52], US | diabetics | VHA | NP/PA & physician | Primary care provider |
Other study designs | ||||
Fletcher et al. (mixed methods) [53], US | unspecific | VHA | NP & physician/MD/ doctor | According to NPs they practice autonomously with physician back up. According to physicians NPs are physician extenders. (Supplement) |
Dierick-van Daele et al. (mixed methods) [54], NL | unspecific | unspecific: single practice, group practice, health centre | GP & NP | Collaborator in a team, role dependent on practice needs and incentives (Supplement) |
Sustaita et al. (review) [55], US | unspecific | unspecific: various practices | NP & physician | Independent providers with a unique approach to health care who do not substitute physicians (Supplement) |
Freund et al. (comparison) [56], NL | unspecific | unspecific: primary practices | GP, NP, extended role practice nurse, practice nurse/auxiliary | Part of primary care team focusing on minor illnesses. |
Helms et al. (case study) [57], AU | unspecific | unspecific: bulk-billing health care cooperative | NP & GP | Collaborator, providing complimentary care |
unspecific | unspecific: primary care practice in the US | physician, NP, RN, PA | Approximation of that of a physician’s, primary care practitioner | |
Hunter et al. (mixed methods) [59], CA | unspecific | unspecific: rural community practice | HCP, healthcare leaders, NP, PCP | Collaborator with PCP and HCP (Supplement and Substitute) |
Collins (mixed methods) [60], UK | unspecific | unspecific: out-of-hours care | GP & NP | Primary care provider |