Highlights
- •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.
Abstract
Background
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.
Purpose
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.
Methods
Logistic regression models were conducted to calculate the adjusted odds of having
a greater than 30-min drive time.
Findings
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.
Discussion
Allowing NPs full autonomy to practice may be a relatively simple policy mechanism
for states to improve access to primary care.
Keywords
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Article info
Publication history
Published online: March 08, 2018
Accepted:
March 5,
2018
Received:
November 15,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
