title: Patient Preference and Perception of Care Provided by Advance Nurse Practitioners and Physicians in Outpatient Adult Congenital Clinics.
abstract: OBJECTIVE
  Nurse practitioners (NPs) have an established role for delivering competent care to patients in the primary care setting. The aim of this study was to compare satisfaction of patients managed by NPs vs. physicians in the outpatient adult congenital heart disease (CHD) clinic.
  
  
  METHODS
  A prospective study conducted in two outpatient adult CHD clinics to assess patient satisfaction through standardized surveys. Demographic data included CHD diagnosis, age, and New York Heart Association functional class. All patients completed a Short-Form-12 to assess health status.
  
  
  RESULTS
  Of the 371 patients recruited (52% men; median age 29 years, severe CHD complexity 31.5%) and seen by NP (n = 187) or physician (n = 184), physician-managed practices had higher perceived: overall experience, courtesy of provider (P < 0.05) and confidence (trust) in provider (P < 0.1). Overall, patients reported satisfaction with an NP providing care (98%), the NP was able to effectively deal with illness/CHD (95%), and an increased chance (94%) or willingness to see an NP at a future visit. Only 73% reported an understanding of NP training and how an NP differed from a registered nurse. There was a stronger perception of how an NP differed from a physician (83%).
  
  
  CONCLUSIONS
  Patient satisfaction was high regardless of whether care was provided by physicians or NPs. However, patients appear to make distinctions in what they believe the type of care each practitioner is best at providing. Patient education regarding competence of the different health care providers may continue to improve patient satisfaction.
authors.affiliation: Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Maul
authors.affiliation: Cardiology, The Columbus Ohio Adult Congenital Heart Program (COACH), Columbus, OH, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Zaidi
authors.affiliation: The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Kowalski
authors.affiliation: Cardiology, The Columbus Ohio Adult Congenital Heart Program (COACH), Columbus, OH, USA.
authors.forename: Jenne
authors.initials: J
authors.lastname: Hickey
authors.affiliation: Cardiology, The Columbus Ohio Adult Congenital Heart Program (COACH), Columbus, OH, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Schnug
authors.affiliation: The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Hindes
authors.affiliation: The Adult Congenital Heart Disease Center, Heart Institute Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cook
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D009820:Ohio; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D057240:Patient Preference; D010414:Pennsylvania; D010465:Perception; D019555:Physician-Nurse Relations; D010817:Physician-Patient Relations; D010820:Physicians; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adult; Congenital Heart Disease; Nurse Practitioner; Patient Satisfaction; Quality Care; Treatment Outcomes