For example, the researchers found five studies in which there was a "high level of evidence" that care provided by nurse practitioners achieved glucose control levels comparable to care provided by physicians, and three studies that had similar findings for patients being managed for lipid levels.
They found studies showing high levels of confidence that outcomes of nursing care were similar to outcomes of physician care in blood pressure control, urgent or emergency care visits, rates of hospitalization and rehospitalization of patients in nursing homes and ambulatory care settings, and in mortality rates.
For certified nurse midwives, the report found high evidence that care was equal to that provide by physicians in rates of cesarean section, and in rates of low Apgar scores.
In a few categories the researchers found only moderate evidence that care was equal to physicians. For example, three studies of initiation of breast feeding found only moderate evidence that nurse midwife care was comparable to that provided by physicians.
The literature analysis drew many of the conclusions contained in a lengthy Institute of Medicine report last October regarding expanding the purview of the nursing profession to improve access to care as well as quality.
The Johns Hopkins report focuses attention on a controversial topic because several physician groups, including the American Academy of Family Physicians, the American Osteopathic Association, the American Academy of Pediatrics and the American Medical Association have opposed certain expansions of advanced practice nurses to provide types of care normally reserved for physicians or osteopaths.