Nurse practitioners' impact on primary health care outcomes in rural clients
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Abstract
The purpose of this descriptive cross-sectional study was to determine if a significant difference exists in perceived primary health care outcomes of rural clients treated by nurse practitioners and those treated by physicians or physician assistants. Primary health care outcomes were defined as (a) perceived satisfaction with care, (b) compliance with antibiotic medications, and (c) perceived health.
Three hypotheses were tested: (1) There is a significant difference in satisfaction with care among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant. (2) There is a significant difference in compliance with antibiotic medications among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant. (3) There is a significant difference in perceived health among rural clients treated by a nurse practitioner and those treated by a physician or a physician assistant.
Descriptive statistics were used to describe the sample demographics. ANOVA and t -tests were used to test for significant group mean differences for each of the three hypotheses. The sample of 151 subjects (a) were age 18 or older, (b) could read and understand English, and (c) lived in a pre-defined rural county. The majority of subjects were female, white, and married.
There was no significant difference found in satisfaction with care or compliance with antibiotic medications among rural clients treated by a nurse practitioner and those treated by a physician or physician assistant. Clients of nurse practitioners had higher levels of perceived health, general health, and physical health than clients of physicians or physician assistants.
Rural clients in this study were more satisfied with nurse practitioners in relation to general satisfaction, interpersonal manner, time spent with health care provider, and accessibility and convenience. Financially, rural clients in this study were more satisfied when treated by physicians and nurse practitioners when compared to physician assistants.
Nurse practitioners are independent practitioners of primary health care. This study supports nurse practitioners as valuable providers of primary health care in rural environments.