Algorithm-directed care by nonphysician practitioners in a pediatric population. Part II. Clinical outcomes, patient satisfaction, and costs of care.
We compared outcome and cost of care for 2234 pediatric patients with upper respiratory tract infections cared for by nonphysician practitioners and 304 similar patients cared for by pediatricians. We found no significant differences (p greater than 0.05) between nonphysician practitioners' patients and pediatricians' patients in the status of the original symptoms, the number of patients reporting new symptoms, the number of return visits, or the reasons for return visits. Approximately 93 per cent of both groups had no complaints about their care. Medication costs were higher for Pamosists than pediatricians, but lower labor costs caused Pamosist care to be 15.5 per cent ($2.64) less expensive than pediatrician care in this setting, even when the costs of Pamosist audit by computer were included. Through use of clinical algorithms with computer audit, relatively untrained nonphysician practitioners can deliver safe, cost-effective health care to pediatric patients with upper respiratory infections.
D000488:Allied Health Personnel / Q000592:standards*; D002648:Child; D002662:Child Health Services / Q000191:economics; D003258:Consumer Behavior; D006801:Humans; D008433:Mathematics; D008887:Military Medicine; D009722:Nurse Practitioners / Q000592:standards; D011320:Primary Health Care / Q000191:economics*; D011369:Professional-Patient Relations; D014481:United States; D000078329:Workforce