Costs and effects of new professional roles: Evidence from a literature review

Abstract

One way in which governments are seeking to improve the efficiency of the health care sector is by redesigning health services to contain labour costs. The aim of this study was to investigate the impact of new professional roles on a wide range of health service outcomes and costs. A systematic literature review was performed by searching in different databases for evaluation papers of new professional roles (published 1985-2013). The PRISMA checklist was used to conduct and report the systematic literature review and the EPHPP-Quality Assessment Tool to assess the quality of the studies. Forty-one studies of specialist nurses (SNs) and advanced nurse practitioners (ANPs) were selected for data extraction and analysis. The 25 SN studies evaluated most often quality of life (10 studies), clinical outcomes (8), and costs (8). Significant advantages were seen most frequently regarding health care utilization (in 3 of 3 studies), patient information (5 of 6), and patient satisfaction (4 of 6). The 16 ANP studies evaluated most often patient satisfaction (8), clinical outcomes (5), and costs (5). Significant advantages were seen most frequently regarding clinical outcomes (5 of 5), patient information (3 of 4), and patient satisfaction (5 of 8). Promoting new professional roles may help improve health care delivery and possibly contain costs. Exploring the optimal skill-mix deserves further attention from health care professionals, researchers and policy makers.

Validity and reliability of an adapted German version of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education Instrument, version 2 (SPICE-2D)

“…The higher the score, the more agreement participants showed with the items on the 5-Point Likert Scale with 1 representing 'strongly disagree' and 5 meaning 'strongly agree' responsibilities within patient care and are often considered to be integral to healthcare teams in primary and secondary care alike. [31,32] The lower scores on SPICE-2D compared with SPICE-2 support this reasoning. Similarly, the low reliability of the roles/responsibilities factor may be because roles and responsibilities have not yet been clearly defined for healthcare professionals in interprofessional teams in Germany.…”

“…This makes international comparisons of IPE initiatives difficult. In countries like the UK and the United States, healthcare professions such as pharmacists and nurses have a wider range of responsibilities within patient care and are often considered to be integral to healthcare teams in primary and secondary care alike . The lower scores on SPICE‐2D compared with SPICE‐2 support this reasoning.…”

Determining cancer survivors' preferences to inform new models of follow-up care

“…The current data (Curtis and Burns, 2015) shows that, in the UK a clinical nurse specialist has an hourly unit cost of £59 compared with £60 for a registrar, £118 for a GP and £138 for a surgical consultant. Furthermore, there is evidence that specialist nurses in extended roles can improve healthcare delivery and contain costs (Tsiachristas et al , 2015). Given current constraints in primary care in the UK, there are likely to be challenges in accommodating (even if acceptable to patients) the additional workload associated with transferring follow-up from secondary to primary care.…”

Reconfiguring health workforce: a case-based comparative study explaining the increasingly diverse professional roles in Europe

“…Second, further research is needed into the effect of diversification of health care teams on the effectiveness and efficiency of care. Although, there is some evidence that skill-mix change may help improve healthcare quality and contain healthcare costs [39], it is largely unknown how different skill-mix arrangements affect outcomes for patients, professionals and the healthcare system, in different care pathways.…”