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Related Concept Videos

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Related Experiment Video

Updated: Dec 13, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

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Published on: June 11, 2012

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Nurse Practitioner Autonomy and Complexity of Care in Rural Primary Care.

Hannah T Neprash1, Laura Barrie Smith1, Bethany Sheridan2

  • 1University of Minnesota, Minneapolis, MN, USA.

Medical Care Research and Review : MCRR
|July 31, 2020
PubMed
Summary

Nurse practitioners (NPs) in rural areas show greater clinical autonomy than urban NPs, practicing independently and prescribing controlled substances. Care complexity remains similar across settings, supporting the perception of enhanced rural NP autonomy.

Keywords:
nurse practitionersprimary carerural health carescope of practice

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Last Updated: Dec 13, 2025

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12:08

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Published on: June 11, 2012

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Area of Science:

  • Healthcare delivery
  • Rural health
  • Advanced practice nursing

Background:

  • Primary care shortages persist in rural US areas.
  • Nurse practitioners (NPs) are increasingly filling these gaps.
  • Understanding NP practice patterns is crucial for healthcare policy.

Purpose of the Study:

  • To compare the clinical autonomy and care complexity of rural versus urban nurse practitioners.
  • To provide empirical evidence on NP practice in diverse settings.

Main Methods:

  • Utilized nationwide claims and Electronic Health Record (EHR) data from 2017.
  • Constructed measures for NP clinical autonomy and care complexity.
  • Compared rural and urban primary care practices.

Main Results:

  • Rural NPs demonstrated greater clinical autonomy compared to urban NPs.
  • Rural NPs were more likely to manage independent patient panels and prescribe Schedule II substances.
  • Care complexity was comparable between rural and urban NPs.

Conclusions:

  • Findings support the perception of increased NP autonomy in rural practice settings.
  • This study offers the first claims- and EHR-based evidence on rural NP autonomy.
  • Understanding these differences can inform strategies to optimize primary care delivery.