Both Brown and Grimes (1992)2 and Crosby et al. (1987)21 found authors of primary studies rarely described the processes of care used by nurse-providers and physician-providers. Research is incomplete on the analyses of cost-effectiveness as well as patient outcome variables such as quality of life and functional status. Almost all of the research studies are based on urban settings, leaving little information on the impact of NPs in rural areas, a major practice site for NPs.