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Cheaper Nurses Can Lift Profits In Medical Practices - Study

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Fuseworks Media
Fuseworks Media
Cheaper Nurses Can Lift Profits In Medical Practices - Study

Wellington, Aug 3 NZPA - Medical practices could make more money by using practice nurses -- paid two thirds less than a doctor -- to provide some of the primary care for patients, including straightforward consultations, according to a new study.

A practice nurse cost-benefit analysis released on the Ministry of Health's website used results of a literature review and data from nine New Zealand primary care practices to estimate the financial impact of "task substitution" between nurses and GPs late last year.

"The findings are clear that practice nurses can .... provide a broad set of primary care services, including undifferentiated general consultations," said the report

In two of the practices studied, in Wellington and on the West Coast, nurses were providing between 40 percent and 50 percent of the total clinical consultations.

Separate research has shown equivalent or superior outcomes for nurse consults in primary care.

The report predicted increased use of nurse time for tasks where the remuneration was the same regardless of who carried out the work, including immunisations, management of chronic conditions, telephone calls and lab results calls, and face-to-face consults in very low-cost access practices.

In a study of immunisation, the average hour pay rate of a general practitioner was $85.39, compared with $25.68 for a nurse, and $18.69 for a receptionist.

A computer model, with an assumed GP hourly rate of $80 plus 5 percent for continuing medical education costs, and allowing for all kinds of paid leave, generated a cost per working minute of $1.75. A nursing hourly rate of $29 per hour generated a cost per worked minute of 59c.

"Nurse cost per minute is 34 percent of GP cost per minute," the report said. "Given this ratio, all other things being equal, it will always be more cost-effective to use a nurse to deliver a given service".

Every time a GP gave an immunisation taking 10 minutes, it cost the practice $11.60 more in labour costs to deliver the vaccine than it would have had the nurse delivered it.

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