Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners
The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Med...
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| Veröffentlicht in: | Health Affairs Jg. 37; H. 6; S. 908 - 914 |
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| Hauptverfasser: | , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
The People to People Health Foundation, Inc., Project HOPE
01.06.2018
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| ISSN: | 0278-2715, 2694-233X, 1544-5208, 2694-233X |
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| Abstract | The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008-16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery. |
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| AbstractList | The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008-16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery. The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008-16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery.The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008-16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery. The use of nurse practitioners (NPs) in primary care is one way to address growing patient demand and improve care delivery. However, little is known about trends in NP presence in primary care practices, or about how state policies such as scope-of-practice laws and expansion of eligibility for Medicaid may encourage or inhibit the use of NPs. We found increasing NP presence in both rural and nonrural primary care practices in the period 2008–16. At the end of the period, NPs constituted 25.2 percent of providers in rural and 23.0 percent in nonrural practices, compared to 17.6 percent and 15.9 percent, respectively, in 2008. States with full scope-of-practice laws had the highest NP presence, but the fastest growth occurred in states with reduced and restricted scopes of practice. State Medicaid expansion status was not associated with greater NP presence. Overall, primary care practices are embracing interdisciplinary provider configurations, and including NPs as providers can strengthen health care delivery. |
| Author | Martsolf, Grant Richards, Michael R. Barnes, Hilary McHugh, Matthew D. |
| Author_xml | – sequence: 1 givenname: Hilary surname: Barnes fullname: Barnes, Hilary organization: Hilary Barnes is an assistant professor in the School of Nursing, University of Delaware, in Newark – sequence: 2 givenname: Michael R. surname: Richards fullname: Richards, Michael R. organization: Michael R. Richards is an assistant professor of health policy at Vanderbilt University, in Nashville, Tennessee – sequence: 3 givenname: Matthew D. surname: McHugh fullname: McHugh, Matthew D. organization: Matthew D. McHugh is a professor of nursing; the Independence Chair for Nursing Education, Center for Health Outcomes and Policy Research; and a senior fellow at the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania, in Philadelphia – sequence: 4 givenname: Grant surname: Martsolf fullname: Martsolf, Grant organization: Grant Martsolf is a professor in the Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, and an adjunct policy researcher at the RAND Corporation in Pittsburgh, both in Pennsylvania |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29863933$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright The People to People Health Foundation, Inc., Project HOPE Jun 2018 |
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| SubjectTerms | Beneficiaries Collaboration Cross-Sectional Studies Female Health care Health care delivery Health care policy Health Care Surveys Health services Humans Interdisciplinary aspects Internet Male Medicaid Medical practices Medicare Nurse practitioners Nurse Practitioners - legislation & jurisprudence Nurse Practitioners - supply & distribution Nurse's Role Nurses Outcome Assessment (Health Care) Patient satisfaction Patients Physician assistants Physicians Physicians, Primary Care - organization & administration Practice Patterns, Physicians' - organization & administration Primary care Primary Health Care - organization & administration Quality of Health Care Rural areas Rural Health Services - organization & administration Rural Population Scope of practice State policies Trends Uninsured people United States Urban Population Welfare recipients Workforce |
| Title | Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners |
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