Nurse practitioner job preference: A discrete choice experiment.

Area of Science:

• Healthcare Management
• Nursing Workforce Studies
• Health Economics

Background:

• Nurse practitioners (NPs) are crucial for healthcare access, but high turnover rates (10%) incur significant costs ($85K-$115K per episode).
• Limited understanding exists regarding NP job preferences and potential organizational cost savings by meeting these preferences.

Purpose of the Study:

• Identify key job characteristics influencing NP job choices.
• Quantify the compensation required for NPs to practice without their preferred job attributes.

Main Methods:

• A two-stage mixed-methods approach was employed in Georgia, USA.
• Stage 1 involved a focus group to identify preferred NP job characteristics.
• Stage 2 utilized a discrete choice experiment with 372 actively employed NPs to rank preferences and compensation needs using a mixed logit model.

Main Results:

• NPs significantly devalued non-cohesive teams (β=-1.50), unresponsive administration (β=-1.04), physician supervision (β=-0.58), lack of patient panels (β=-0.42), and not billing under their own NPI (β=-0.18).
• NPs require substantial compensation for practicing without preferred characteristics: $21,780 for non-cohesive teams, $15,280 for unresponsive administration, and $21,450 for physician supervision.

Conclusions:

• A supportive, cohesive work environment and practice independence are paramount for NP job satisfaction and retention.
• Healthcare organizations should cultivate workplace cultures aligning with NP preferences to mitigate turnover.
• Policy reforms supporting independent NP practice are recommended to enhance retention and address workforce needs.