• Skill mix

Skill mix

This working paper from the Organisation for Economic Co-operation and Development (OECD) examines "skills-mix" between nurses and physicians in hospital and primary-care settings. The research was particularly focused on the use of advanced practice nurses (APN) or specialist nurses in terms of effectiveness and cost-effectiveness. Most of the findings are from the United States (US) and the United Kingdom (UK), though this is supplemented by findings from a survey of sixteen OECD countries.

This research supported the findings of previous work which showed that nurses can provide medical care that is equivalent to that provided by doctors in primary care settings. Nurses order more tests and have longer consultations with patients and patients are more satisfied with nurse consultations. The research also found that innovative nurse telephone consultation services were cost-effective since they reduced the levels of hospital admissions. In other areas the results on cost-effectiveness were mixed. Of the sixteen countries which responded to the survey, half currently have some level of nurses involved in advanced practice roles and a further three reported plans for pilot projects. The case studies from the US and the UK investigate the drivers behind the implementation of the APN role, and the legal and policy changes which were necessary.

• Full text of document
• Publisher details
• Send to a friend