Nurse practitioners: a comparison of rural-urban practice patterns and willingness to serve in underserved areas

To determine nurse practitioners' (NPs) practice patterns and willingness to practice in underserved areas in both rural and urban settings in a largely rural state.

A census of all NPs holding a Pennsylvania license and providing addresses in Pennsylvania or one of the contiguous states was conducted in 1996. The ZIP codes of practice sites were matched with 1990 census data.

Nurse practitioners in rural areas are more likely than their urban counterparts to provide primary care in primary care practice settings, they see more patients per week, and they are more likely to be the principal provider of care for a higher percentage of their patients. Experience with managed care contracts is greater for urban NPs as is their willingness to practice in urban underserved areas. Rural NPs were more willing to practice in rural underserved areas than their urban counterparts.

Access to primary care continues to be a concern in rural areas. The increasing market penetration of managed care and the deficit of primary care providers in rural environments may lead to increased opportunities for NPs in the rural health care delivery system.