Nurse Practitioners and Physicians: A comparison of perceived Health Care outcomes and perceived satisfaction with care




Pinkerton, JoAllyn

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A comparison of patient health care outcomes and satisfaction of care by nurse practitioners and physicians in a managed care setting was the purpose of this study. The study's conceptual framework joined the Shuler and Davis (1993) nurse practitioner practice model with Donabiden's (1966) theory of structure, process and outcomes.

The participants, a nonrandom sample of 160 patients, (NP, n=80 and MD, n=80), received health care from an outpatient clinic in a large teaching hospital. Study participation required that each patient have a medical diagnosis of hypertension and/or diabetes mellitus, was seen by the same provider for the last six months, and could read and understand English.

Two instruments were used, a 20 item multiscale, health survey from the Medical Outcomes Study (SF-20) by Stewart et al., 1988 and Ware, 1989, a 15 item patient satisfaction scale, the Nurse Practitioner Satisfaction Instrument (NPSI) by Knudtson (1995). A demographic sheet was included.

The sample gender ratio was 70/30 female to male. The mean age was 55 years with an ethnic makeup of 48% Caucasian, 36% Black, 9.5% Hispanic, 1% Asian and 4% Other. Thirty percent of the sample reported that they were married. Fifty-three patients had both hypertension and diabetes, 85 had only hypertension, and 22 had only diabetes mellitus.

Hypothesis One was tested using an independent sample t-test for differences in health care outcomes by provider. There was no statistically significant difference in patient health care outcomes according to provider. Hypothesis Two was tested using an independent sample t-test for differences in patient satisfaction according to provider. No statistically significant difference in patient satisfaction was found according to provider.

Exploratory data analysis indicated heavy data distribution in the tails. A Kolmogorov-Smirnov 2-Sample (Asymptotic) nonparamentric test determined that data distribution was the same for both provider groups. Health care outcome and patient satisfaction was equivalent for nurse practitioners' and physicians' patients in this managed care setting.



Health care, Occupational psychology, Job satisfaction