Medical Care by Nurses

Abstract

To the Editor.— This letter is prompted by the article of Spector et al (232:1234, 1975). The authors were not aware of our recent reports relating to outcome data and costs of the physician-backed nursing care provided chronic disease patients. 1,2 Our studies showed, as did Spector et al, that professional contacts increased after patients were transferred to nurse and physician care but differed in that hospital days were reduced by about 50% over a four-year period. The larger share of this reduction in hospital days was due to a decrease in the preventable complications of hypertension, diabetes, and cardiac disease. Our outcome data suggest that blood pressure levels in hypertensive patients and blood glucose values in diabetics are maintained adequately by the nurse physicianbacked nursing care. We also agree that the care provided in our program is not possible using algorithms but do find that detailed protocols define courses