Abstract
In a randomized trial of nurse practitioners as providers of primary clinical services, attention was devoted to the "outcomes" of clinical effectiveness and safety. These outcomes—expressed in physical, emotional, and social function—were assessed with newly developed methods that could be applied easily and objectively by nonclinicians to the two groups of patients under study: patients receiving conventional care and patients receiving care from nurse practitioners. Besides showing the comparability of these groups at the start of this study, these measurements showed similar levels of physical, emotional, and social function in the two groups after 1 year of receiving either nurse-practitioner or conventional care. Since the numbers of patients were large enough for a statistical detection of even small differences, the results indicate that the nurse practitioners were effective and safe. This study provides a base from which to explore the "process" of delivering primary clinical services by nurse practitioners.
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