State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019.

Autor:	Ryskina KL; Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104, United States., Liang J; Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States., Ritter AZ; NewCourtland, Philadelphia, PA 19119, United States.; School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, United States., Spetz J; School of Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA 94158, United States., Barnes H; Widener University School of Nursing, Chester, PA 19013, United States.
Jazyk:	angličtina
Zdroj:	Health affairs scholar [Health Aff Sch] 2024 Feb 12; Vol. 2 (2), pp. qxae018. Date of Electronic Publication: 2024 Feb 12 (Print Publication: 2024).
DOI:	10.1093/haschl/qxae018
Abstrakt:	Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state scope of practice regulations on NP practice in nursing homes in 2012-2019. Using linear probability models, we estimated the proportion of NP-delivered visits to patients in nursing homes as a function of state scope of practice regulations. Control variables included county demographic, socioeconomic, and health care workforce characteristics; state fixed effects; and year indicators. The proportion of nursing home visits conducted by NPs increased from 24% in 2012 to 42% in 2019. Expanded scope of practice regulation was associated with a greater proportion and total volume of nursing home visits conducted by NPs in counties with at least 1 NP visit. These relationships were concentrated among short-stay patients in urban counties. Removing scope of practice restrictions on NPs may address clinician shortages in nursing homes in urban areas where NPs already practice in nursing homes. However, improving access to advanced clinician care for long-term care residents and for patients in rural locations may require additional interventions and resources. Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials. (© The Author(s) 2024. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.)
Databáze:	MEDLINE
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