Readmissions after appointments with nurse prescribers: A register-based study

Area of Science:

• Health Services Research
• Nursing Practice
• Patient Outcomes

Background:

• Nurse prescribers can address physician shortages, enhance treatment access, and control healthcare costs.
• However, patient readmission rates following nurse prescriber appointments require further investigation.

Purpose of the Study:

• To compare initial appointments between nurse prescribers and physicians.
• To investigate client readmissions within 60 days post-appointment for both nurse prescribers and physicians.

Main Methods:

• Retrospective register-based follow-up study conducted in a Finnish hospital district.
• Analysis of 3986 client appointments and 9038 client readmissions between January 2018 and December 2019.
• Statistical analysis included frequencies, percentages, rate ratios, and cross-tabulation, adhering to STROBE guidelines.

Main Results:

• Nurse prescribers handled 2131 initial appointments, while physicians handled 1855.
• Average 60-day readmissions per appointment were 2.10 for nurse prescribers and 2.46 for physicians.
• While specific antibiotic prescriptions (phenoxymethyl penicillin) showed higher readmissions with nurse prescribers, overall readmission rates were higher after physician appointments.

Conclusions:

• Clients experienced fewer readmissions after nurse prescriber appointments compared to physician appointments, even with similar prescriptions.
• Nurse prescribers' full potential may not be realized, as physicians treated conditions within nurse prescriber scope.
• Physician clients may present with more complex care needs, potentially influencing readmission rates.