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Physician substitution by mid‐level providers in primary healthcare for older people and long‐term care facilities: protocol for a systematic literature review
Author(s) -
Lovink Marleen H.,
Persoon Anke,
Vught Anneke J.A.H.,
Koopmans Raymond T.C.M.,
Schoonhoven Lisette,
Laurant Miranda G.H.
Publication year - 2015
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12759
Subject(s) - protocol (science) , primary care , substitution (logic) , health care , medicine , primary health care , medline , long term care , family medicine , term (time) , nursing , alternative medicine , environmental health , computer science , population , pathology , political science , law , physics , quantum mechanics , economics , programming language , economic growth
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 , Psyc INFO , 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.