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Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes.

Judith Ortiz1, Richard Hofler2, Angeline Bushy3

  • 1College of Health and Public Affairs, University of Central Florida, Orlando, FL 32816, USA. Judith.Ortiz@ucf.edu.

Healthcare (Basel, Switzerland)
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Summary

This study found no difference in patient outcomes for older adults in rural areas regardless of nurse practitioner (NP) scope of practice regulations. Expanded NP practice may improve healthcare access and quality.

Keywords:
nurse practitionerspatient outcomesruralrural workforcescope of practice

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Area of Science:

  • Healthcare Policy
  • Rural Health
  • Nursing Practice

Background:

  • U.S. rural areas face persistent primary care provider shortages.
  • Nurse practitioners (NPs) play a crucial role in mitigating these shortages.
  • State regulations on NP scope of practice vary significantly, impacting their autonomy.

Purpose of the Study:

  • To investigate whether clinical outcomes for older rural adult patients differ based on state-level NP practice autonomy.
  • To compare patient outcomes in states with reduced NP practice regulations versus those with restricted regulations.

Main Methods:

  • Cross-sectional study analyzing data from 503 Rural Health Clinics (RHCs) in eight Southeastern states.
  • Independent t-tests compared patient outcomes between RHCs in 'reduced practice' and 'restricted practice' states.
  • Patient outcomes were assessed across five key variables.

Main Results:

  • No statistically significant differences in patient outcomes were observed between RHCs in reduced practice states and those in restricted practice states.
  • The study did not find a direct relationship between Advanced Registered Nurse Practitioner (ARNP) scope of practice and select patient outcome variables.
  • Expanded scope of practice for NPs may enhance provider supply, healthcare access, utilization, and overall quality of care.

Conclusions:

  • While no significant relationship was found between ARNP scope of practice and the specific patient outcomes studied, quality of care was not compromised.
  • Findings suggest that expanding the scope of practice for NPs does not negatively impact patient outcomes in rural settings.
  • Further research may explore broader impacts of NP scope of practice on healthcare delivery and patient well-being.