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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results1 to 4 of 4 Research Studies Displayed
The effect of nurse practitioner scope of practice laws on primary care delivery.
Nurse practitioners (NPs) are an increasingly integral part of the primary care workforce. NPs' authority to practice without physician oversight is regulated by state-level scope of practice (SOP) restrictions. To the extent that SOP restrictions prevent NPs from practicing to their full abilities and capacity, they could create inefficiencies and restrict access to health care. The purpose of this paper was to explore what occurs at primary care practices when states ease their scope of practice (SOP) laws. The researcher utilized a novel dataset of claims and electronic health records to quantify the effects of easing SOP laws in 3 areas: 1. Nurse Practitioners' autonomy in their everyday jobs; 2. Total workload and the allocation of patients between physicians and NPs; and 3. The delivery of low-value services at primary care practices. The study found no evidence that easing SOP laws impacts neither the volume or allocation of patients to NPs, nor the delivery of low-value services.
Citation: Smith LB . The effect of nurse practitioner scope of practice laws on primary care delivery. Health Econ 2022 Jan; 31(1):21-41. doi: 10.1002/hec.4438..
Keywords: Primary Care, Healthcare Delivery, Policy, Provider: Clinician, Provider: Nurse
Kandrack R, Barnes H, Martsolf GR
Nurse practitioner scope of practice regulations and nurse practitioner supply.
This study’s objective was to estimate associations between adopting full nurse practitioner (NP) scope of practice (SOP) and improved access to care. The authors used county-level data to estimate the association between adopting full NP SOP and NP supply in general, and in rural and health professional shortage area-designed counties specifically. They estimated positive associations, although the relationship was only statistically significant in health professional shortage areas.
Citation: Kandrack R, Barnes H, Martsolf GR . Nurse practitioner scope of practice regulations and nurse practitioner supply. Med Care Res Rev 2021 Jun;78(3):208-17. doi: 10.1177/1077558719888424..
Keywords: Provider: Nurse, Provider: Clinician, Workforce, Policy
Patel EY, Petemann V, Mark BA
Does state-level nurse practitioner scope-of-practice policy affect access to care?
This study attempts to fill a critical gap between policy reform that grants state-level nurse practitioners (NPs) scope of practice (SOP) and a useful synthesis of empirical studies that assesses the relationship of NP SOP policy to its impact on access to care. Researchers applied Aday and Andersen's Access Framework to operationalize access to care and to map components of access to care that might relate to NP SOP through concepts identified in their review. Their findings suggest that full state-level NP SOP policy is associated with increases in various components of access to care, but that additional work will be required to evaluate causality and underlying mechanisms behind the policy's effect on access.
Citation: Patel EY, Petemann V, Mark BA . Does state-level nurse practitioner scope-of-practice policy affect access to care? West J Nurs Res 2019 Apr;41(4):488-518. doi: 10.1177/0193945918795168..
Keywords: Access to Care, Policy, Provider, Provider: Clinician
Mark BA, Patel E
Nurse practitioner scope of practice: what do we know and where do we go?
This article discusses how state-level nurse practitioner (NP) scope of practice (SOP) policies effect access to primary care. In states where SOP policies became less restrictive, patients reported better access to healthcare including increased availability of appointments, greater checkup utilization, decreased emergency visits for ambulatory care, and decreased administrative burden for physicians. There have been a number of studies in states that have restrictive NP SOP policies, and they do not improve quality of care. It was found that states that still had restrictive policies tended to have more political pressure by physician groups than those states and repealed it.
Citation: Mark BA, Patel E . Nurse practitioner scope of practice: what do we know and where do we go? West J Nurs Res 2019 Apr;41(4):483-87. doi: 10.1177/0193945918820338..
Keywords: Policy, Primary Care, Provider: Nurse, Provider: Clinician, Provider