The impact of nurse practitioner regulations on population access to care
•People living in states with independent nurse practitioner (NP) regulations had
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| Veröffentlicht in: | Nursing outlook 2018-07, Vol.66 (4), p.379-385 |
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| container_end_page | 385 |
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| container_issue | 4 |
| container_start_page | 379 |
| container_title | Nursing outlook |
| container_volume | 66 |
| creator | Neff, Donna Felber Yoon, Sul Hee Steiner, Ruth L. Bejleri, Ilir Bumbach, Michael D. Everhart, Damian Harman, Jeffrey S. |
| description | •People living in states with independent nurse practitioner (NP) regulations had |
| doi_str_mv | 10.1016/j.outlook.2018.03.001 |
| format | Article |
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By 2025, experts estimate a significant shortage of primary care providers in the United States, and expansion of the nurse practitioner (NP) workforce may reduce this burden. However, barriers imposed by state NP regulations could reduce access to primary care.
The objectives of this study were to examine the association between three levels of NP state practice regulation (independent, minimum restrictive, and most restrictive) and the proportion of the population with a greater than 30-min travel time to a primary care provider using geocoding.
Logistic regression models were conducted to calculate the adjusted odds of having a greater than 30-min drive time.
Compared with the most restrictive NP states, states with independent practice had 19.2% lower odds (p = .001) of a greater than 30-min drive to the closest primary care provider.
Allowing NPs full autonomy to practice may be a relatively simple policy mechanism for states to improve access to primary care.</description><identifier>ISSN: 0029-6554</identifier><identifier>EISSN: 1528-3968</identifier><identifier>DOI: 10.1016/j.outlook.2018.03.001</identifier><identifier>PMID: 29703627</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Drive time ; Nurse practitioner scope of practice ; Nursing ; Population access to care ; State NP practice regulations</subject><ispartof>Nursing outlook, 2018-07, Vol.66 (4), p.379-385</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-16ca583e01e180f94c0e839a52b96e147e24caa54e49cf884f1f2339f811ad13</citedby><cites>FETCH-LOGICAL-c365t-16ca583e01e180f94c0e839a52b96e147e24caa54e49cf884f1f2339f811ad13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.outlook.2018.03.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29703627$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neff, Donna Felber</creatorcontrib><creatorcontrib>Yoon, Sul Hee</creatorcontrib><creatorcontrib>Steiner, Ruth L.</creatorcontrib><creatorcontrib>Bejleri, Ilir</creatorcontrib><creatorcontrib>Bumbach, Michael D.</creatorcontrib><creatorcontrib>Everhart, Damian</creatorcontrib><creatorcontrib>Harman, Jeffrey S.</creatorcontrib><title>The impact of nurse practitioner regulations on population access to care</title><title>Nursing outlook</title><addtitle>Nurs Outlook</addtitle><description>•People living in states with independent nurse practitioner (NP) regulations had <30-min drive to their primary health care practice.•In states with restrictive NP practice, NPs are geographically colocated with supervising MDs.•Restricted NP practice limits their ability to provide care in areas that lack access to primary health-care providers.•In states with restrictive NP regulations, NPs are not practicing to their full scope of practice.
By 2025, experts estimate a significant shortage of primary care providers in the United States, and expansion of the nurse practitioner (NP) workforce may reduce this burden. However, barriers imposed by state NP regulations could reduce access to primary care.
The objectives of this study were to examine the association between three levels of NP state practice regulation (independent, minimum restrictive, and most restrictive) and the proportion of the population with a greater than 30-min travel time to a primary care provider using geocoding.
Logistic regression models were conducted to calculate the adjusted odds of having a greater than 30-min drive time.
Compared with the most restrictive NP states, states with independent practice had 19.2% lower odds (p = .001) of a greater than 30-min drive to the closest primary care provider.
Allowing NPs full autonomy to practice may be a relatively simple policy mechanism for states to improve access to primary care.</description><subject>Drive time</subject><subject>Nurse practitioner scope of practice</subject><subject>Nursing</subject><subject>Population access to care</subject><subject>State NP practice regulations</subject><issn>0029-6554</issn><issn>1528-3968</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkMtOwzAQRS0EoqXwCSAv2SSMH0nsFUIVj0qV2HRvue4EXNI42AkSf0-qFrasRlc6d0ZzCLlmkDNg5d02D0PfhPCRc2AqB5EDsBMyZQVXmdClOiVTAK6zsijkhFyktAUAKSt9TiZcVyBKXk3JYvWO1O8663oaatoOMSHt4hh970OLkUZ8Gxq7D4mGlnahO0ZqncOUaB-osxEvyVltm4RXxzkjq6fH1fwlW74-L-YPy8yJsugzVjpbKIHAkCmotXSASmhb8LUukckKuXTWFhKldrVSsmY1F0LXijG7YWJGbg9ruxg-B0y92fnksGlsi2FIhoPgEiqm9YgWB9TFkFLE2nTR72z8NgzMXqLZmqNEs5doQJhR4ti7OZ4Y1jvc_LV-rY3A_QHA8c8vj9Ek57F1uPERXW82wf9z4gfTl4YJ</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Neff, Donna Felber</creator><creator>Yoon, Sul Hee</creator><creator>Steiner, Ruth L.</creator><creator>Bejleri, Ilir</creator><creator>Bumbach, Michael D.</creator><creator>Everhart, Damian</creator><creator>Harman, Jeffrey S.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201807</creationdate><title>The impact of nurse practitioner regulations on population access to care</title><author>Neff, Donna Felber ; Yoon, Sul Hee ; Steiner, Ruth L. ; Bejleri, Ilir ; Bumbach, Michael D. ; Everhart, Damian ; Harman, Jeffrey S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-16ca583e01e180f94c0e839a52b96e147e24caa54e49cf884f1f2339f811ad13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Drive time</topic><topic>Nurse practitioner scope of practice</topic><topic>Nursing</topic><topic>Population access to care</topic><topic>State NP practice regulations</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neff, Donna Felber</creatorcontrib><creatorcontrib>Yoon, Sul Hee</creatorcontrib><creatorcontrib>Steiner, Ruth L.</creatorcontrib><creatorcontrib>Bejleri, Ilir</creatorcontrib><creatorcontrib>Bumbach, Michael D.</creatorcontrib><creatorcontrib>Everhart, Damian</creatorcontrib><creatorcontrib>Harman, Jeffrey S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nursing outlook</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neff, Donna Felber</au><au>Yoon, Sul Hee</au><au>Steiner, Ruth L.</au><au>Bejleri, Ilir</au><au>Bumbach, Michael D.</au><au>Everhart, Damian</au><au>Harman, Jeffrey S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of nurse practitioner regulations on population access to care</atitle><jtitle>Nursing outlook</jtitle><addtitle>Nurs Outlook</addtitle><date>2018-07</date><risdate>2018</risdate><volume>66</volume><issue>4</issue><spage>379</spage><epage>385</epage><pages>379-385</pages><issn>0029-6554</issn><eissn>1528-3968</eissn><abstract>•People living in states with independent nurse practitioner (NP) regulations had <30-min drive to their primary health care practice.•In states with restrictive NP practice, NPs are geographically colocated with supervising MDs.•Restricted NP practice limits their ability to provide care in areas that lack access to primary health-care providers.•In states with restrictive NP regulations, NPs are not practicing to their full scope of practice.
By 2025, experts estimate a significant shortage of primary care providers in the United States, and expansion of the nurse practitioner (NP) workforce may reduce this burden. However, barriers imposed by state NP regulations could reduce access to primary care.
The objectives of this study were to examine the association between three levels of NP state practice regulation (independent, minimum restrictive, and most restrictive) and the proportion of the population with a greater than 30-min travel time to a primary care provider using geocoding.
Logistic regression models were conducted to calculate the adjusted odds of having a greater than 30-min drive time.
Compared with the most restrictive NP states, states with independent practice had 19.2% lower odds (p = .001) of a greater than 30-min drive to the closest primary care provider.
Allowing NPs full autonomy to practice may be a relatively simple policy mechanism for states to improve access to primary care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29703627</pmid><doi>10.1016/j.outlook.2018.03.001</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0029-6554 |
| ispartof | Nursing outlook, 2018-07, Vol.66 (4), p.379-385 |
| issn | 0029-6554 1528-3968 |
| language | eng |
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| source | ScienceDirect Journals (5 years ago - present) |
| subjects | Drive time Nurse practitioner scope of practice Nursing Population access to care State NP practice regulations |
| title | The impact of nurse practitioner regulations on population access to care |
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