States With The Least Restrictive Regulations Experienced The Largest Increase In Patients Seen By Nurse Practitioners
States With The Least Restrictive Regulations Experienced The Largest Increase In Patients Seen By Nurse Practitioners
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DOI：
10.1377/hlthaff.2013.0072
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发表时间：
2013-07-01
期刊：
影响因子：
9.7
通讯作者：
Goodwin, James S.
中科院分区：
文献类型：
--
作者：
Kuo, Yong-Fang;Loresto, Figaro L., Jr.;Goodwin, James S.
使用执业护士（NP）是解决初级保健医生短缺问题的一种方法。过去二十年里，护士培训项目和执业护士数量不断增加。然而，限制其执业范围的法规因州而异。我们使用 5% 的全国 Medicare 受益人样本，评估了州法规对美国 NP 提供的护理增加的影响。我们发现，1998 年至 2010 年间，接受 NP 护理的医疗保险患者数量增加了 15 倍。到 2010 年，对 NP 实践限制最少的州患者从 NP 接受初级护理的可能性比限制最严格的州高 2.5 倍。放松国家对 NP 执业的限制应该会增加 NP 作为初级保健提供者的使用，这反过来又会减少目前全国初级保健提供者的短缺。
The use of nurse practitioners (NPs) is one way to address the shortage of physician primary care providers. NP training programs and the number of practicing NPs have increased in the past two decades. However, regulations limiting their scope of practice vary greatly by state. We assessed the impact of state regulations on the increase in care provided by NPs in the United States, using a 5 percent national sample of Medicare beneficiaries. We found that between 1998 and 2010 the number of Medicare patients receiving care from NPs increased fifteenfold. By 2010 states with the least restrictive regulations of NP practice had a 2.5-fold greater likelihood of patients' receiving their primary care from NPs than did the most restrictive states. Relaxing state restrictions on NP practice should increase the use of NPs as primary care providers, which in turn would reduce the current national shortage of primary care providers.