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Healthcare 2018, 6(2), 65; https://doi.org/10.3390/healthcare6020065

Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes

1
College of Health and Public Affairs, University of Central Florida, Orlando, FL 32816, USA
2
College of Business Administration, University of Central Florida, Orlando, FL 32816, USA
3
College of Nursing, University of Central Florida, Orlando, FL 32816, USA
4
College of Sciences, University of Central Florida, Orlando, FL 32816, USA
*
Author to whom correspondence should be addressed.
Received: 15 May 2018 / Revised: 4 June 2018 / Accepted: 11 June 2018 / Published: 15 June 2018
(This article belongs to the Special Issue Rural and Remote Nursing)
Full-Text   |   PDF [199 KB, uploaded 15 June 2018]

Abstract

Background: For decades, U.S. rural areas have experienced shortages of primary care providers. Nurse practitioners (NPs) are helping to reduce that shortage. However, NP scope of practice regulations vary from state-to-state ranging from autonomous practice to direct physician oversight. The purpose of this study was to determine if clinical outcomes of older rural adult patients vary by the level of practice autonomy that states grant to NPs. Methods: This cross-sectional study analyzed data from a sample of Rural Health Clinics (RHCs) (n = 503) located in eight Southeastern states. Independent t-tests were performed for each of five variables to compare patient outcomes of the experimental RHCs (those in “reduced practice” states) to those of the control RHCs (in “restricted practice” states). Results: After matching, no statistically significant difference was found in patient outcomes for RHCs in reduced practice states compared to those in restricted practice states. Yet, expanded scope of practice may improve provider supply, healthcare access and utilization, and quality of care (Martsolf et al., 2016). Conclusions: Although this study found no significant relationship between Advanced Registered Nurse Practitioner (ARNP) scope of practice and select patient outcome variables, there are strong indications that the quality of patient outcomes is not reduced when the scope of practice is expanded. View Full-Text
Keywords: nurse practitioners; rural; scope of practice; patient outcomes; rural workforce nurse practitioners; rural; scope of practice; patient outcomes; rural workforce
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Ortiz, J.; Hofler, R.; Bushy, A.; Lin, Y.-L.; Khanijahani, A.; Bitney, A. Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes. Healthcare 2018, 6, 65.

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