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Nurse Practitioners: Limiting the Trade-Off between Quality and Cost

Thesis advisor: Christopher Maxwell / Though much research has been done on the subject of substituting nurse practitioners for physicians as health care providers, both analytic methods and results have been inconsistent. Various studies have shown nurse practitioners to provide equivalent or improved care especially in primary care settings. However, no consensus has been reached on whether or not and under what conditions this substitution is economically efficient. Because of variation in productivity and substitution rates, the economic viability of nurse practitioners must be assessed on a department specific basis, taking into account differences in nurse practitioners’ job descriptions.One specific area this economic efficiency could be assessed in is in the diagnosis of ear infections. A study conducted through the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey showed that 15% of pediatric visits included a diagnosis of middle ear infection (Freid, 1998). If employed properly, nurse practitioners could be used to achieve significant cost savings in this area.This thesis is intended to address the economic efficiency of nurse practitioners as compared to physicians in diagnosing ear infections. First nurse practitioner quality in this specific area will be assessed by comparing nurse practitioner diagnosis error rates to physician error rates based on surveys asking both types of providers to provide diagnoses based on tympanic membrane images collected through previous telemedicine visits. Next the economic practicality of employing nurse practitioners in this field will be assessed in terms of the relative costs of these errors, measured as the cost of unnecessary prescriptions in the case of overdiagnosis and the cost of an unnecessary follow-up visit in the case of underdiagnosis. / Thesis (BA) — Boston College, 2012. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program. / Discipline: Economics Honors Program. / Discipline: Economics.

Identiferoai:union.ndltd.org:BOSTON/oai:dlib.bc.edu:bc-ir_102482
Date January 2012
CreatorsConnolly, Margaret Julia
PublisherBoston College
Source SetsBoston College
LanguageEnglish
Detected LanguageEnglish
TypeText, thesis
Formatelectronic, application/pdf
RightsCopyright is held by the author, with all rights reserved, unless otherwise noted.

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