Abstract
This paper describes a methodology to delineate factors associated with consumer acceptance of the medical nurse practitioner (MNP). The MNP is a category of new health practitioners with proficiency in medical/health care functions traditionally performed only by physicians. A process model approach was developed to study the significance of selected sociodemographic cognitive, attitudinal, and clinical/medical factors that are expected to predispose consumer acceptance of the MNP. The survey population consists of predominantly elderly and indigent ambulatory patients to an inner-city primary care clinic. The data were collected from 156 primary care patients before and after the introduction of the MNP program. The results clearly demonstrate consumer support for the new health practitioner concept. This finding is further substantiated in the “after” study. From an analysis of symptoms experience, symptom severity, and type of symptoms, symptoms experience emerged as the strongest indicator of consumer receptivity to MNP concept. Additionally, exposure to MNP caused the consumer to become more aware of proper consumption and increased the demand for physician care and specialty care where appropriate.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Goldberg, G. A., Jolly, D. M., Hosek, S., and Chu, D. S., Physician's extenders' Performance in Air Force clinics.Med. Care 19:951, 1981.
Reinhardt, U. E., Physician productivity and the demand for health manpower. Ballinger, Cambridge, Massachusetts, 1975.
Schneider, D. P., and Kilpatrick, K. E., An optimal manpower utilization model for health maintenance organizations.Oper. Res. 23:869, 1975.
Stimson, D. H., and Charles, G., The study of physician extenders in primary care.Health Serv. Res. 10:6, 1975.
Smith, K. R., Over, A. M., Jr., Hansen, M. E., Golladay, F. L., and Davenport, E. J., Analytical framework and measurement strategy for investigating optimal staffing in medical practice.Oper. Res. 24:815, 1976.
Winston, S., Nurse practitioners: A case study of the Washington Hospital Center.Hosp. Topics 59:4, 1981.
Pondy, L., Jones, J., and Braun, J., Utilization and productivity of the Duke physician's associate.Socio-Econ. Plan Sci. 7:227, 1973.
Golladay, F. L., Manser, M. E., and Smith, K. R., Scalke economics in the delivery of medical care: A mixed integer programming analysis of efficient manpower utilization.J. Hum. Resources 23:869, 1975.
Reed, D. E., and Roghmann, K. J., Acceptability of expanded nurse role to nurses and physicians.Med. Care 9:372, 1971.
Strunk, H. K.,A study of patient attitudes toward the physician's assistant University of California, Los Angeles, 1972.
Sackett, D. L., et al., The Burlington randomized trial of the nurse practitioner health outcomes of patients.Ann. Intern. Med. 80:137–142, 1974.
Spitzer, W. O., et al., The Burlington randomized trial of the nurse practitioner.N. Engl. J. Med. 90:251–256, 1974.
Lewis, CH. E., Cheyovich, TH. K., Who is a nurse practitioner? Processes of care and patients' perceptions.Med. Care 14:365, 1976.
Linn, L. S., Patient acceptance of the family nurse practitioner.Med. Care 14:357, 1976.
Record, J. C., Blomquist, R. H., Berger, B. D., and O'Bannon, J. E., Physician supervision of PAs: How much is enough? And what does it cost? Bliss AA, Cohen ED, eds.The New Health Professionals: Nurse Practitioners and Physician Assistants (A. A. Bliss and E. D. Cohen, eds.), Aspen Systems Corporation, Germantown, Maryland, 1977.
Sox, H. C., Jr., Quality of patient care by nurse practitioners and physician's assistants: A ten-year perspective.Ann. Intern. Med. 91:459, 1979.
Appel, G. L., and Lowin, A., Physician extenders: An evaluation of policy-related research, InterStudy, Minneapolis, 1975. (NSF-C814).
Lawrence, D., Physician assistants and nurse practitioners: Their impact on health care access costs and quality.Health Med. Care Serv. Rev. 1:1, 1978.
Perry, H. B., An analysis of the professional performance of physician's assistants.J. Med. Educ. 52:639, 1977.
Lewis, C. E., Resnik, B. A., Schmidt, G., and Waxman, D., Activities, events and outcomes in ambulatory patient care.N. Engl. J. Med. 280:645, 1969.
Levine, D. M., Morlock, L. L., Mushlin, A. I., Shapiro, S., and Malitz, F. E., The role of new health practitioners in a prepaid group practice: Provider differences in process and outcomes of medical care.Med. Care 14:326, 1976.
Komaroff, A. L., Black, W. L., Flatley, M., Knopp, R. H., Reiffen, B., and Sherman, H., Protocols for physician assistants.N. Engl. J. Med. 290:307, 1974.
Tompkins, R. K., Wood, R. W., Wolcott, B. W., and Walsh, B. T., The effectiveness and cost of acute respiratory illness medical care provided by physicians and algorithm-assisted physicians' assistants.Med. Care 15:991, 1977.
Sibley, J. C., Spitzer, W. O., Rudnick, K. V., et al., Quality-of-care appraisal in primary care: A quantitative method.Ann. Intern. Med. 83:46, 1975.
Duttera, M. J., and Harlan, W. R., Evaluation of physician assistants in rural primary care.Arch. Intern. Med. 138:224, 1978.
Kane, R. L., Olson, D. M., and Castle, C. H., Medex and their physician preceptors: Quality of care.J. Am. Med. Assoc. 236:2509, 1976.
Weiss, C. H., Utilization of evaluation: Toward a Comparative study.Readings in Evaluative Research (F. G. Card, ed.), Russell Sage Foundation, New York, 1971.
Chenoy, N. C., Spitzer, W. O., and Anderson, G. D., Nurse practitioners in primary care—11. Prior attitudes of a rural population. Pilot program supported by the Ontario Health Resources Development Plan of the Ontario Ministry of Health (Project D.M. 36), 1973.
Gonella, J. S., Louis, D. Z., and McCord, J. J., The staging concept—an approach to the assessment of outcome of ambulatory care.Med. Care 14:13, 1976.
Greeborn, D. K., and Greenlock, M. R., Evaluation of the performance of ambulatory care systems: Research requirements and opportunities.Med. Care Suppl. 11:68, 1973.
Stafford, H. V. G., The emergency nurse practitioner: The role and training of an emergency health professional.J. Am. Coll. Emergency Physicians 7:372–376, 1978.
Special projects for improvement in nurse training. U.S. Department of Health, Education and Welfare, 1972, p. iii.
Nurse practitioner and physician assistant training and development study. U.S. Department of Health, Education and Welfare 1976, System Sciences, Bethesda, Maryland, 13.
Andreoll, K., Physician assistants and nurse practitioners: A harmonius future.Physician Assist. J. 6:127, 1976.
Bicknell et al. Physician assistants and nurse practitioners in the U.S.: Roadblocks to success.Physician Assist. J. 6:134, 1976.
Tyroler, H. A., and Cordle, F., The use of hospital medical records for epidemiologic research. 1. Differences in hospital utilization and in-hospital mortality by age-race-sex-place of residence and socioeconomic status in defined community populations.Med. Care 12:596, 1974.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Enggist, R.E., Hatcher, M.E. Factors influencing consumer receptivity to the nurse practitioner. J Med Syst 7, 495–512 (1983). https://doi.org/10.1007/BF00995180
Issue Date:
DOI: https://doi.org/10.1007/BF00995180