Health Maintenance Service

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Abstract
The purpose of this study was to compare the health care of two groups of ambulatory patients–those treated primarily by a nurse-clinician under physician supervision, with those treated by attending physicians–in the general medical clinic of a large university teaching hospital. One hundred and sixty-nine new patients were randomly assigned to the Health Maintenance Service (HMS) staffed by the urse-clinician and to the Control Group, staffed by attending physicians. The data based upon patients medical charts and questionnaires revealed that among the HMS patients, there were fewer recorded lapses in care, proportionally fewer whose health conditions were rated as unstable one year after their initial visit, and none whose health condition was judged as deteriorated. The nurse-clinician was able to provide coordinated and continuous medical care for ambulatory patients and the quality of this care appeared to be at least equal to that provided by the physicians.

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