Inpatient management by a nurse practitioner: effectiveness in a rehabilitation setting

The performance of a nurse practitioner, under the supervision of an internist, in managing inpatients in a rehabilitation hospital was assessed by comparison with three similar groups managed by internists. Criteria were chosen to reflect both quality of care and cost-effectiveness. The medical records of 25 patients discharged consecutively on each service were examined to determine length of stay, laboratory and x-ray costs per day, number of consultations, and mean score on six index conditions. The index conditions score was designed to reflect proper recognition and management of the following common medical problems: urinary tract infection, congestive heart failure, anemia, diabetes, hypertension, and hypokalemia. No statistically significant differences were found between the patient groups managed by the supervised nurse practitioner and the independent internists.