MEDLINE Journals

    Nurse practitioners as attending providers for injured workers: evaluating the effect of role expansion on disability and costs.

    Authors

    Sears JM, Wickizer TM, Franklin GM, et al. 

    Source

    Med Care 2007 Dec; 45(12) :1154-61.

    Abstract

    BACKGROUND
    A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented on July 1, 2004. This legislation authorized NPs to independently perform most functions of an attending physician.
    OBJECTIVE
    The purpose of this study was to assess the impact of this legislation by examining medical costs and disability outcomes for injured workers in the care of NPs benchmarked against those in the care of primary care physicians (PCPs).
    RESEARCH DESIGN
    This observational study compared NPs and PCPs in the role of attending provider based on the medical costs and disability outcomes of injured workers in their care. Comparisons controlled for sociodemographics, geographic location, injury, employment, and provider characteristics.
    DATA SOURCE
    The Washington State Department of Labor and Industries provided claim and medical billing data for 29,949 injured workers who had an accident report filed by an NP or PCP between July 1, 2004 and June 30, 2005. Data were collected through June 30, 2006.
    RESULTS
    NPs were more likely than PCPs to be located in rural areas and counties with high unemployment. The distributions of injury type and severity/complexity indicators were similar across provider types. The likelihood of any time loss was lower for NP claims, but duration of lost work time and medical costs did not significantly differ by provider type.
    CONCLUSIONS
    Attending provider type is not a significant predictor of disability or medical costs for injured workers in Washington State.

    Mesh

    Accidents, Occupational
    Adolescent
    Adult
    Aged
    Disabled Persons
    Female
    Health Care Costs
    Humans
    Male
    Middle Aged
    Nurse Practitioners
    Nurse's Role
    Physicians, Family
    Regression Analysis
    Workers' Compensation

    Language

    eng

    Pub Type(s)

    Comparative Study Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

    PubMed ID

    18007165

    Content Manager
    Related Content

    Expanding the role of nurse practitioners: effects on rural access to care for injured workers.

    Nurse practitioners as attending providers for workers with uncomplicated back injuries: using administrative data to evaluate quality and process of care.

    Improving quality, preventing disability and reducing costs in workers' compensation healthcare: a population-based intervention study.

    Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project.

    Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project II: medical and disability costs.

    Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project I: medical outcomes and patient satisfaction.

    Primary care involvement and outcomes of care in patients with a workers' compensation claim for back pain.

    Enhancing the policy impact of evaluation research: a case study of nurse practitioner role expansion in a state workers' compensation system.