Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study

In The European Journal of Public Health, Claudia Maier and Linda Aiken compare patterns of task shifting from physicians to nurses in primary care across 39 countries. Increasing rates of chronic conditions are expected to intensify the need for primary care providers in the future. Using cross-country comparative research as well as literature scoping, the authors surveyed experts on themes such as prescriptive authority, referrals and first point of contact, educational requirements, financing policy, and regulatory reforms. The study finds that task shifting has been implemented in 27 of the 39 countries studied (69%), thus allowing nurses to perform all or a limited set of clinical activities traditionally reserved to physicians. Moreover, many policy and educational reforms have been implemented: between 2010 and 2015, 14 countries enacted or expanded prescriptive authority for nurses in strictly regulated contexts, which is causing shifts in the skill-mix and design of teams in primary care.