The role of new health practitioners in a prepaid group practice: changes in the distribution of ambulatory care between physician and nonphysician providers of care.

Changes in the distribution of ambulatory care between physicians and new health practitioners (NHP) are examined in the pediatric and adult medicine departments of a prepaid group practice program. The study covers a three-year period during which NHP were extensively introduced to provide a broad range of ambulatory care. The source of data is a routine data information system that utilizes an encounter form to capture a minimal data set on every patient visit, including the provider's statement of diagnosis. Based on these data, changes in staffing are related to changes in workload and content of practice of both physicians and NHP.