A study led by two economists suggested nurse practitioners may be less productive than physicians in the emergency department setting.
The study, which is not peer-reviewed, examined Veterans Health Administration administrative health records between January 2017 and January 2020. Nurse practitioners have been able to practice independently at VA facilities since 2016. Researchers analyzed 1.1 million cases from 44 different emergency department sites. The study included 156 NPs and 1,348 physicians.
Economists David Chan, MD, PhD, and Yiqun Chen, PhD, who are both affiliated scholars at the National Bureau of Economic Research, looked at two primary indicators of productivity: resource use and patient outcomes. The report found the following:
- Nurse practitioners increase length of stay by 11 percent.
- Nurse practitioners raise the cost of ED care by 7 percent.
- Nurse practitioners raise 30-day preventable hospitalizations by 20 percent.
- Nurse practitioners decreased opioid prescriptions by 1.8 percent.
- Nurse practitioners increased antibiotic prescriptions by 4 percent.
"However, we also find productivity variation within each of the professions that are even larger than the difference between professions," Drs. Chan and Chen said.
"While physicians have occupied a dominant position in society since the turn of the 20th century, the rising demand for healthcare in an aging population and the limited supply of physicians have set the stage for the rise of NPs to challenge the monopoly of physicians over the independent provision of medical care," they added.
Editor's note: This article was updated Jan. 20 at 12:38 p.m. CT.