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The financial impact of clinical task substitution between practice nurses and GPs in New Zealand primary care centres

Hefford, Martin, Love, Tom, Cumming, Jacqueline, Finlayson, Mary P. and Raymont, Antony (2011). The financial impact of clinical task substitution between practice nurses and GPs in New Zealand primary care centres. New Zealand Medical Journal (Online Edition),124(1342):59-65.

Document type: Journal Article
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IRMA ID 83093774xPUB180
Title The financial impact of clinical task substitution between practice nurses and GPs in New Zealand primary care centres
Author Hefford, Martin
Love, Tom
Cumming, Jacqueline
Finlayson, Mary P.
Raymont, Antony
Journal Name New Zealand Medical Journal (Online Edition)
Publication Date 2011
Volume Number 124
Issue Number 1342
ISSN 1175-8716   (check CDU catalogue open catalogue search in new window)
Start Page 59
End Page 65
Total Pages 7
Place of Publication New Zealand
Publisher New Zealand Medical Association
HERDC Category C1 - Journal Article (DIISR)
Abstract Aim
To describe the financial impact on practice owners of increased clinical task substitution between practice nurses and GPs in New Zealand (NZ) primary care settings.

Method
Case studies of 9 primary health care centres involving: interviews; collation of service and financial information; and nurse and GP diaries covering 1826 consultations. Results were compared with previous NZ large N survey results to develop a model predicting the financial impact of task substitution.

Results
The proportion of general practice primary care consultations undertaken by nurses varied from 4% to 46% of total recorded consultations. The actual financial impact for a practice owner of substituting more nursing time for GP time is highly dependent on the following variables: nurse cost per minute relative to GP cost minute; nurse consult duration relative to GP consult duration; nurse consult revenue relative to GP consult revenue; and the proportion of nurse consults also requiring GP time.

Conclusion
Practice nurses can (and in some practices in NZ, do) provide a broad set of primary care services, including undifferentiated general consultations. For some practices, increasing the proportion of nurse consults and reducing GP consults, would result in significantly improved profitability—for others, the opposite applies. Clinical task substitution is one option to address the forecast increase in demand associated with population aging.
Description for Link Link to published version
URL http://journal.nzma.org.nz/journal/124-1342/4862/


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