重新构想初级保健提供:评估执业护士所拥有的初级保健实践
Alicia Korpi Ortiz1, Wendy Wright1, Joan Romboli2
1Duet Technologies, Inc., New York, NY, USA.
Journal of the American Association of Nurse Practitioners
|September 11, 2025
概括
实践护士 (NP) 拥有的实践提供可访问的初级保健,特别是在服务不足的地区. 然而,它们面临着影响长期可持续性和可扩展性的财务和行政障碍.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理是指初级护理.
- 卫生政策 卫生政策
背景情况:
- 执业护士 (NP) 拥有的实践对初级保健提供越来越重要,特别是在服务不足的社区.
- 完全执业权限 (FPA) 的州显示,NP自雇率增长,医疗保健获得改善.
- 基于保险的NP业务实践的运营现实和挑战仍未得到充分探索.
研究的目的:
- 描述非国有企业所拥有的初级保健实践.
- 分析访问,服务提供和财务可持续性.
- 为了确定NP实践所有权的具体挑战.
主要方法:
- 采用了并发混合方法设计.
- 收集了来自19家非营利企业拥有的实践的调查答案.
- 分析了来自6个FPA州的电子健康记录数据.
主要成果:
- 大多数实践都是独资企业,由女性/少数民族领导,并以收费服务模式运营.
- 远程医疗 (90%) 和当天预约的高度采用,平均患者小组较小 (867).
- 主要挑战包括不充分的报销 (79%),行政负担 (74%) 和有限的基于价值的护理 (VBC) 参与,尽管患者获得的机会很高.
结论:
- 在服务不足的地区,NP-owned实践提供了可访问的,以患者为中心的护理.
- 与可扩展性和财务可持续性相关的系统性障碍阻碍了NP-owned实践.
- 支持公平补偿和VBC的政策变化对于NP所有实践的可持续性至关重要,以满足初级保健需求.
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