Contribution of community-based nurse-led clinics to health care access and patient outcomes

Added May 15, 2020

Citation: Randall S, Crawford T, Currie J, et al. Impact of community-based nurse-led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review. International Journal of Nursing Studies 2017; 73: 24-33.

Free to view: No

What is this? The COVID-19 pandemic is placing a strain on healthcare services. Community-based nurse-led clinics (NLC) may help increase patient access whilst maintaining quality of care.

In this systematic review, the authors searched for research literature related to community based NLCs. They did not restrict by type of publication and included peer-reviewed studies based in primary or community care settings, published in English between 2006 and 2016. They identified 15 studies (8 quantitative, including two randomised studies, 5 qualitative, and 3 mixed methods studies) including 3965 participants, which examined one or more of the following: patient outcomes, satisfaction, access and cost effectiveness.

What was found: There were high levels of patient satisfaction with NLCs. NLCs improve patient access to care as a result of community-based case management.

Most of the studies reviewed showed general improvement in various aspects of patient health.

Behavioural changes such as secondary health promotion and preventative practices (sex education leading to safer sex practices, and smoking cessation) were noted with NLCs.

Improvement in objective clinical outcomes such as ulcer healing time, improved body mass index in obese children, improved immunisation and management of upper respiratory tract infection was noted following services provided by NLCs.

There were mixed results for cost-effectiveness. There is some evidence that NLCs are cost-equivalent or cheaper than standard doctor-led services and can be cost-effective in terms of reduced hospital utilisation and readmission.

What doesn’t work: Nothing noted.

What’s uncertain: The full financial impact of NLCs has been insufficiently evaluated and hence is uncertain.

The most effective evaluation methods for community-based NLCs often lack rigor and, therefore, result in some degree of uncertainty.

The studies included in this review tended to present self-reported outcome data, with only three studies evaluating measurable patient outcomes.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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