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State health and the level of practice authority for nurse practitioners
Jacqueline Dunbar-Jacob1, Jeffrey M Rohay1
1University of Pittsburgh School of Nursing, Pittsburgh, PA.
Background:
Studies show positive outcomes for nurse practitioner care compared with physicians, in a variety of clinical settings. Of unique interest is the relationship of nurse practitioner level of practice authority (NP-LPA) and population health.
Purpose:
Does state population health differ by NP-LPA?
Methods:
United Foundation Annual Reports (2019 and 2021) provided data on state health rankings. The American Association of Nurse Practitioners website (2021) provided data on NP-LPA. Analyses used Fisher's exact test to compare the top 25 v. the bottom 25 ranked states.
Results:
Full NP-LPA states ranked higher than reduced or restricted on overall state health, health outcomes, clinical care, quality of care, access to care, number of primary care providers per 100,000 population, and childhood immunizations.
Discussion:
States with legislated full NP-LPA showed better population health. The data suggest full NP-LPA could address shortages in primary care while achieving greater population health.
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