Johns Hopkins University School of Nursing, Baltimore, MD.
Johns Hopkins University School of Nursing, Baltimore, MD.
Nurs Outlook. 2020 Jul-Aug;68(4):459-467. doi: 10.1016/j.outlook.2020.05.008. Epub 2020 Jun 24.
Full practice authority laws that permit nurse practitioners (NPs) to practice independently and prescribe medications may influence NPs' workforce outcomes.
To examine whether implementation of full practice authority laws affect NP self-employment, average earnings, and likelihood of residing in a primary care health professional shortage area (HPSA).
A nationally representative U.S. sample of 9,782 NPs employed in health care during 2010 to 2018 was drawn from the American Community Survey. Difference-in-differences regression was used to estimate covariate-adjusted mean differences in NPs' workforce outcomes after full practice authority implementation.
Among full-time employed NPs, full practice authority was associated with an increased probability of residing in a HPSA (adjusted odds ratio [aOR]:2.34, 95%CI 1.14, 4.83) and with a higher mean probability of self-employment (aOR:4.97, 95%CI 1.00, 24.86).
Full practice authority implementation improves access to primary care providers in health professional shortage areas and may increase practice ownership among NPs.
允许执业护士（NP）独立执业和开处方的全面执业权限法可能会影响 NP 的劳动力结果。
检验全面执业权限法的实施是否会影响 NP 的自营职业、平均收入以及居住在初级保健卫生专业人员短缺地区（HPSA）的可能性。
使用来自美国社区调查的 2010 年至 2018 年期间从事医疗保健工作的 9782 名具有代表性的美国 NP 全国样本，采用差分法回归分析，估计在全面执业权限实施后 NP 劳动力结果的协变量调整均值差异。
在全职受雇的 NP 中，全面执业权限与居住在 HPSA 的可能性增加相关（调整后的优势比[aOR]：2.34，95%CI 1.14，4.83），自营职业的平均可能性也更高（aOR：4.97，95%CI 1.00，24.86）。
全面执业权限的实施改善了卫生专业人员短缺地区获得初级保健提供者的机会，并可能增加 NP 的实践所有权。
