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The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study

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  • Ammi, Mehdi
  • Ambrose, Sarah
  • Hogg, Bill
  • Wong, Sabrina

Abstract

Nurses, whether registered nurses (RNs) or nurse practitioners (NPs), are becoming key providers of primary care services. While evidence for the influence of NPs on patient experience in primary care is mounting, this is less so for RNs. We use the Canadian component of the international Quality and Costs of Primary Care 2013/14 survey to investigate the mechanisms by which nurses can affect patients’ experience in primary care, focusing on accessibility and appropriateness of care. The data allow us to distinguish between family practice RNs, specialised RNs and NPs, and covers all types of patients visiting a primary care clinic in a variety of contexts in all Canadian provinces. In addition to the types of nurses and full-time equivalent (FTE) numbers, we explore the role of nurse autonomy and collaboration. Our regression results show that one of the most important predictors of patient experience is the collaboration between health professionals, whereas nurse staffing in terms of FTE numbers has little influence by itself. Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic. Our results can inform decision-makers on how to strengthen primary care provision, and particularly in Canadian context, the adaptation of the recently implemented interprofessional primary care teams.

Suggested Citation

  • Ammi, Mehdi & Ambrose, Sarah & Hogg, Bill & Wong, Sabrina, 2017. "The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study," Health Policy, Elsevier, vol. 121(12), pages 1215-1224.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:12:p:1215-1224
    DOI: 10.1016/j.healthpol.2017.09.019
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    References listed on IDEAS

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    1. Sarma, Sisira & Thind, Amardeep & Chu, Man-Kee, 2011. "Do new cohorts of family physicians work less compared to their older predecessors? The evidence from Canada," Social Science & Medicine, Elsevier, vol. 72(12), pages 2049-2058, June.
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    1. Óscar Brito Fernandes & Petra Baji & Dionne Kringos & Niek Klazinga & László Gulácsi & Armin Lucevic & Imre Boncz & Márta Péntek, 2019. "Patient experiences with outpatient care in Hungary: results of an online population survey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 79-90, June.
    2. Kuhlmann, Ellen & Groenewegen, Peter P. & Bond, Christine & Burau, Viola & Hunter, David J., 2018. "Primary care workforce development in Europe: An overview of health system responses and stakeholder views," Health Policy, Elsevier, vol. 122(10), pages 1055-1062.

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