By Penny Smith

Substituting nurse practitioners, physician assistants, and nurses for physicians in healthcare for the aging population may achieve healthcare quality at least as good as care provided by physicians, according to a review of published studies.

The review assessed outcomes such as patient morbidity, mortality, satisfaction, and quality of life; quality of healthcare; provider workload and job satisfaction; medication use; and costs. Evidence from two randomized controlled trials showed no effect on approximately half of the outcomes and a positive effect on the other half of these outcomes. Evidence from eight studies with other comparative study designs supported most of the results of the randomized trials.

"Additional well-designed studies are needed to draw affirmative conclusions regarding quality of healthcare, costs and cost-effectiveness," wrote the authors of the review.