执业护士执业范围法律对可预防的住院治疗的影响
1University of Alabama School of Law, 101 Paul W. Bryant Dr East, Tuscaloosa, AL 35487, United States of America.
Journal of health economics
|August 3, 2025
概括
扩大执业护士 (NP) 的实践范围减少了可预防的慢性病入院. 授予完整的实践权限可以改善门诊患者的访问,并优化住院患者的资源使用.
科学领域:
- 卫生政策 卫生政策
- 获得医疗保健 获得医疗保健 获得医疗保健
- 护理实践 护理实践
背景情况:
- 执业护士 (NPs) 对获得医疗保健至关重要,但限制性执业范围的法律阻碍了他们的全部潜力.
- 美国大约一半的州有法律限制NP实践权限,影响护理提供.
- 预防质量指标 (PQI) 识别了在适当的门诊护理下可能可以预防的住院病例.
研究的目的:
- 评估放宽国家级NP实践范围法律对PQI条件下出院的影响.
- 确定授予NP全面执业权限是否会影响慢性疾病的可避免住院治疗.
主要方法:
- 分析了2010年至2019年间来自22个州的医院出院数据.
- 与PQI相关的住院治疗趋势的比较,在各州授予NP完全执业权之前和之后.
- 根据保险状况对结果进行分层,以评估差异性影响.
主要成果:
- 授予NP完全执业权限与PQI条件的住院减少有关,包括糖尿病和其他慢性疾病.
- 这些积极影响在私人保险患者中尤为一致.
- 对于PQI条件的平均住院时间增加了,这表明更健康的患者被从住院护理中转移.
结论:
- 扩大NP的实践范围,或全面的实践权限,提高了获得基本门诊护理的机会.
- 允许NP更大的自主权的政策变化可以导致更有效地利用医院资源.
- 这些发现支持旨在利用NP劳动力来改善人口健康结果的政策改革.
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