title: Nurse practitioner managed care for persons with HIV infection.
abstract: This exploratory study examined whether outcomes of care for HIV-infected patients are related to whether the patient's primary provider is a physician (MD) or a nurse practitioner (NP). Functional status, symptom occurrence, self management, health service use and patients' assessment of their care were evaluated for 87 HIV-infected patients in a teaching hospital outpatient setting. NP patients were three times as likely to report their health status as only fair or poor (odds-ratio = 3.06, p = .028), and reported significantly more unpleasant symptoms over a four-week period. Despite being in poorer health than patients cared for by physicians, NP patients functioned at comparable levels and used no more health care services than MD patients. NP patients reported 45 percent fewer problems with their care (p = 0.003). Findings suggest that more extensive use of nurse practitioners could safely enhance access to care for persons with HIV-related illnesses.
authors.affiliation: Center for Health Services and Policy Research, University of Pennsylvania 19104-6096.
authors.forename: L H
authors.initials: LH
authors.lastname: Aiken
authors.forename: E T
authors.initials: ET
authors.lastname: Lake
authors.forename: S
authors.initials: S
authors.lastname: Semaan
authors.forename: H P
authors.initials: HP
authors.lastname: Lehman
authors.forename: P A
authors.initials: PA
authors.lastname: O'Hare
authors.forename: C S
authors.initials: CS
authors.lastname: Cole
authors.forename: D
authors.initials: D
authors.lastname: Dunbar
authors.forename: I
authors.initials: I
authors.lastname: Frank
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000191:economics / Q000451:nursing* / Q000628:therapy; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000191:economics; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D010347:Patient Care Planning / Q000191:economics / Q000458:organization & administration*; D017060:Patient Satisfaction; D015143:Philadelphia; D010820:Physicians