Primary care practice structural capabilities in health professional shortage areas.

OBJECTIVES

To evaluate structural capabilities in primary care practices employing nurse practitioners (NPs) and test whether they differ across health professional shortage areas (HPSAs) and non-HPSAs.

STUDY DESIGN

Secondary analysis of cross-sectional survey data and health care workforce data from 2018-2019.

METHODS

We computed bivariate analyses and multivariable adjusted regression models to evaluate differences in NP characteristics and practice characteristics and to determine the odds of having particular structural capabilities in HPSA practices compared with non-HPSA practice.

RESULTS

The majority of NPs worked in HPSA practices (61%). We found statistically significant differences in NP educational degrees, practice certifications, and structural capabilities between HPSAs and non-HPSAs. Care coordination was 77% more likely to be delivered in HPSA practices compared with non-HPSA practices (odds ratio, 1.77; P < .05).

CONCLUSIONS

Expanding care coordination may be beneficial for HPSA populations with high rates of morbidity and socioeconomic needs. Future research is needed to understand how the NP workforce may be optimized to meet the growing primary care demands in underserved areas.