Germack Hayley D, Harrison Jordan, Poghosyan Lusine, Martsolf Grant R
University of Pittsburgh, Pittsburgh, PA, USA.
RAND Corporation, Pittsburgh, PA, USA.
Med Care Res Rev. 2022 Feb;79(1):161-170. doi: 10.1177/1077558720974537. Epub 2020 Nov 19.
As nurse practitioners (NPs) are increasingly relied on to deliver primary care in rural communities, it is critical to understand the contexts in which they work and whether they are characterized by work environments and infrastructures that facilitate the provision of high-quality patient care. This study compares urban and rural NPs using data from a survey of 1,244 primary care NPs in Arizona, California, New Jersey, Pennsylvania, Texas, and Washington. While rural and urban NPs have a number of similarities in terms of demographic characteristics, practice patterns, and job outcomes, they also have noteworthy differences. Rural NPs report higher levels of independent practice, fewer structural capabilities that facilitate quality care, and poorer relationships with physicians. Health care organizations in rural communities may need to invest in work environments and infrastructures that facilitate high-quality care and autonomous practice for NPs.
随着执业护士（NPs）越来越多地被依赖于在农村社区提供初级保健服务，了解他们的工作环境以及这些环境是否具备有助于提供高质量患者护理的工作环境和基础设施至关重要。本研究使用对亚利桑那州、加利福尼亚州、新泽西州、宾夕法尼亚州、得克萨斯州和华盛顿州的1244名初级保健执业护士的调查数据，对城市和农村的执业护士进行了比较。虽然农村和城市的执业护士在人口统计学特征、执业模式和工作成果方面有许多相似之处，但也存在显著差异。农村执业护士报告的独立执业水平更高，有助于提供优质护理的结构能力较少，与医生的关系也较差。农村社区的医疗保健组织可能需要投资于有助于执业护士提供高质量护理和自主执业的工作环境和基础设施。
