Nurse practitioner training and local medical provider supply

Area of Science:

• Health Services Research
• Rural Health Policy
• Workforce Development

Background:

• The Nurse Practitioner (NP) workforce has grown significantly, especially in rural areas, yet rural health outcomes lag behind urban areas.
• Limited empirical research exists on the interaction and substitution effects between NPs and physicians in primary care.
• Rural counties face worsening health outcomes and access to care relative to urban counterparts.

Purpose of the Study:

• To investigate the impact of new graduate nursing programs on the local supply of NPs and primary care physicians.
• To analyze the spillover effects of NP supply increases on surrounding rural and underserved counties.
• To assess the long-term retention and contribution of program graduates to the regional NP workforce.

Main Methods:

• Utilized county-level data on graduate nursing program openings.
• Employed staggered difference-in-differences frameworks using data from IPEDS and AHRF.
• Analyzed the impact on local NP supply and primary care physician numbers over a decade.

Main Results:

• New graduate nursing programs led to substantial increases in local NP supply.
• Positive spillover effects were observed in nearby rural counties and those with low provider-to-population ratios.
• Up to 30% of graduates became licensed NPs in the same county, with the majority contributing to regional supply, especially from rural programs.

Conclusions:

• Establishing graduate nursing programs effectively increases the local and regional supply of NPs.
• NP workforce expansion does not adversely affect the number of primary care physicians, indicating overall provider supply growth.
• Rural medical education is crucial for enhancing primary care access and mitigating health inequities.