Physician substitution by mid-level providers in primary healthcare for older people and long-term care facilities: protocol for a systematic literature review.
J Adv Nurs
; 71(12): 2998-3005, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26383740
ABSTRACT
AIM:
This protocol describes a systematic review that evaluates the effects of physician substitution by mid-level providers (nurse practitioners, physician assistants or nurses) in primary healthcare for older people and long-term care facilities. The secondary aim is to describe facilitators and barriers to the implementation of physician substitution in these settings.BACKGROUND:
Healthcare for older people is undergoing major changes, due to population ageing and reforms that shift care to the community. Besides, relatively few medical students are pursuing careers in healthcare for older people. Innovative solutions are needed to guarantee the quality of healthcare and to contain costs. A solution might be shifting care from physicians to mid-level providers. To date, no systematic review on this topic exits to guide policymaking.DESIGN:
A quantitative systematic literature review using Cochrane methods.METHODS:
The following databases will be searched for original research studies that quantitatively compare care provided by a physician to the same care provided by a mid-level provider PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL and Web of Science. Study selection, data extraction and quality appraisal will be conducted independently by two reviewers. Data synthesis will consist of a qualitative analysis of the data. Funding of the review was confirmed in August 2013 by the Ministry of Health, Welfare and Sport of the Netherlands.DISCUSSION:
This review will contribute to the knowledge on effects of physician substitution in healthcare for older people and factors that influence the outcomes. This knowledge will guide professionals and policy administrators in their decisions to optimize healthcare for older people.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Médicos
/
Assistentes Médicos
/
Atenção Primária à Saúde
/
Assistência de Longa Duração
/
Instituição de Longa Permanência para Idosos
/
Profissionais de Enfermagem
/
Casas de Saúde
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
/
Systematic_reviews
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Adv Nurs
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Holanda