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Health problems encountered by pediatric nurse practitioners and pediatricians in ambulatory care clinics
Insights
Pediatric nurse practitioners (PNPs) and pediatricians manage different health problems, with setting and provider type significantly influencing care distribution. Community settings are ideal for PNPs.
Area of Science:
- Pediatric Healthcare
- Nursing Practice
- Health Services Research
Background:
- Pediatric nurse practitioners (PNPs) and pediatricians are key providers in child healthcare.
- Understanding the scope of practice and caseload differences is crucial for optimizing healthcare delivery.
- Previous research has not fully elucidated how practice setting and provider type influence the distribution of pediatric health problems.
Purpose of the Study:
- To document and compare the health problems managed by PNPs and pediatricians.
- To examine the impact of clinical setting and provider group on the distribution of pediatric health issues.
- To identify specific differences in caseloads and wellness emphases between PNPs and pediatricians.
Main Methods:
- A proportional sampling method was used across five ambulatory care clinics.
- Data were collected from 11,968 patient visits over an 18-week period in 1978.
- A patient encounter form was utilized, with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as the coding system.
Main Results:
- Significant differences were observed in the distribution of health problems managed by PNPs and pediatricians within each clinic.
- The clinical setting demonstrably affected the distribution of both types of health problems.
- Provider group significantly influenced the management of health problems coded with V codes, but not frequently reported problems within a given setting.
Conclusions:
- PNP caseloads exhibit distinct diagnostic categories and wellness emphases compared to pediatricians.
- Community-based settings appear particularly well-suited for nurse practitioner practice.
- These findings highlight the need for tailored healthcare models based on provider type and practice environment.
Abstract:
This study documents the health problems managed by pediatric nurse practitioners (PNPs) and pediatricians and examines the effects of setting and provider group on the distribution of health problems. Proportional samples by clinic were selected from a total of 11,968 patient visits to five ambulatory care clinics during an 18-week period in 1978. A patient encounter form was devised and the ICD-9-CM was used as the coding system. Results indicated 1) distributions of health problems differed significantly between the PNPs and the pediatricians in each clinic; 2) setting significantly effected the distributions of both types of health problems; and 3) provider group significantly affected the distribution of health problems with V codes but not frequently reported problems given a setting. The PNPs caseloads differ from pediatrician caseloads in diagnostic categories and wellness emphases. Community-based settings seem to be especially appropriate for nurse practitioner practice.