Does State-Level Nurse Practitioner Scope-of-Practice Policy Affect Access to Care?

Area of Science:

• Health Services Research
• Nursing Policy
• Healthcare Access

Background:

• Policy debates exist regarding full state-level nurse practitioner (NP) scope of practice (SOP).
• NP SOP is theorized to influence healthcare access, but empirical evidence requires synthesis.
• A systematic review is needed to assess the relationship between NP SOP and access to care.

Purpose of the Study:

• To systematically review empirical studies examining the relationship between full state-level NP SOP and access to care.
• To apply Aday and Andersen's Access Framework to operationalize and analyze components of healthcare access.
• To identify how NP SOP may influence various dimensions of healthcare accessibility.

Main Methods:

• Systematic literature review of studies investigating NP SOP and healthcare access.
• Utilized Aday and Andersen's Access Framework to define and measure access to care.
• Analyzed findings to map components of access influenced by NP SOP.

Main Results:

• Full state-level NP SOP is associated with improvements in multiple components of healthcare access.
• The review identified a positive correlation between expanded NP authority and enhanced access.
• Causality and specific mechanisms require further investigation.

Conclusions:

• Full NP SOP demonstrates a positive association with increased healthcare access.
• Additional research is crucial to establish causality and elucidate the mechanisms driving this relationship.
• Findings support aligning research, practice, and policy to enhance healthcare accessibility through NP SOP.