Effects of Nurse Practitioners on Reducing Medical Fee and Expected Improvement of Patient Care: Simulation Based on Consultation Fee of Visiting Nursing User and Interview with Visiting Nurse

Abstract

This research aimed at conducting a simulation of medical fee when US-style nurse practitioners (NPs) and graduates of medical procedure-specific training were introduced in the Japanese community medicine; it also aimed at revealing the problems of the Japanese community medicine and the expected improvement of patient care by introducing NPs by interviewing visiting nurses. A simulation of medical consultation fees using data of the visiting nursing records and examination records of 69 nurses who made use of the X Home Nursing Station associated with a hospital revealed that on average, using NPs reduced the long-term care insurance and the medical insurance by 29% and 21%, respectively, and using graduates of medical procedure-specific training reduced the long-term care insurance and the medical insurance by 2% and 5%, respectively. Interviews conducted with three visiting nurses affiliated with the facility revealed that they encountered problems such as being able to respond only within the scope of doctors’ instructions and that they hoped sophisticated practitioners such as NPs could act as coordinators of home medicine in the future.