高级实践注册护士全职实践权威,提供者供应和健康结果:边界分析
Kihwan Bae1,2, Conor Norris1, Shishir Shakya3
1The Knee Center for the Study of Occupational Regulation, Morgantown, WV, USA.
Policy, politics & nursing practice
|December 20, 2023
概括
马里兰州高级实践注册护士的全实践权限 (FPA) 增加了执业护士和认证护士助产士的数量. 这一政策变化与改善患者健康结果有关,包括减少健康状况不佳或不良的报告.
科学领域:
- 卫生政策研究 卫生政策研究
- 护理实践扩张 护理实践扩张
- 获得初级保健 获得初级保健
背景情况:
- 越来越多的医生短缺造成了患者获得初级保健的重大障碍.
- 许多州正在制定政策,以减少高级实践注册护士 (APRNs) 提供初级保健的监管障碍.
- 全职执业权 (FPA) 允许APRN在没有医生合作的情况下独立执业.
研究的目的:
- 评估马里兰州全面执业权威 (FPA) 政策对APRN数量和患者健康结果的影响.
- 评估FPA与县级关键健康指标之间的关联.
主要方法:
- 利用马里兰州和宾夕法尼亚州之间的边境县对比分析来估计FPA的影响.
- 分析了县级的健康结果,包括自我报告的健康状况不佳或不错,精神健康状况不佳的日子和可预防的住院治疗.
- 检查了人均认证护士助产士和执业护士数量的变化.
主要成果:
- FPA的实施与每10万居民中0.6名认证护士助产士和22.4名护士从业人员的增加有关.
- 研究人员发现,FPA与报告健康状况不佳或健康状况良好的居民减少2.8个百分点之间存在明显的关联.
- FPA与每人每月心理健康状况不佳减少0.354天的相关性.
结论:
- 这些发现表明,马里兰州的全职执业权与APRN可用性增加有关.
- 政策变化似乎与改善患者健康结果和加强对初级保健的准入有关.
- 减少APRNs的监管障碍可能是解决初级保健准入问题的可行策略,并改善人口健康.
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