Comparison of Access to Nurse Practitioners in Primary Healthcare across Three Team Structures

The addition of nurse practitioners (NPs) in primary healthcare (PHC) is intended to improve accessibility. This study compared access to NP services in consultative, dyad and multiprofessional team structures in Nova Scotia. Accessibility indicators included NP appointment wait times, after-hours coverage and acceptance of new patients. Secondary analysis of province-wide survey data from PHC providers showed multiprofessional structures had shorter median NP appointment wait times: 0.5 days for urgent appointments versus 6.5 days (dyad, p= 0.004) and 4.5 days (consultative, p= 0.003), 4 days for non-urgent appointments versus 15 days (dyad, p= 0.020) and 4.5 days (consultative, p> 0.05). Only NPs in the multiprofessional structure provided after-hours coverage and over half the NPs in each structure were accepting new patients. These results support the use of team-based care and should be considered along with local needs and resources when planning team structures.