Columbia University School of Nursing, 560 W 168th St, New York, NY 10032. Email:
Am J Manag Care. 2022 May;28(5):212-217. doi: 10.37765/ajmc.2022.89142.
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.
Secondary analysis of cross-sectional survey data and health care workforce data from 2018-2019.
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.
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).
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.
评估初级保健实践中使用执业护士（NP）的结构能力，并检验这些能力在卫生专业人员短缺地区（HPSA）和非 HPSA 是否存在差异。
对 2018-2019 年的横断面调查数据和医疗保健劳动力数据进行二次分析。
我们进行了单变量分析和多变量调整回归模型，以评估 NP 特征和实践特征的差异，并确定 HPSA 实践与非 HPSA 实践相比具有特定结构能力的可能性。
大多数 NP 在 HPSA 实践中工作（61%）。我们发现 HPSA 和非 HPSA 之间 NP 教育程度、实践认证和结构能力存在统计学显著差异。HPSA 实践中提供医疗协调的可能性比非 HPSA 实践高 77%（优势比，1.77；P<.05）。
扩大医疗协调可能对发病率和社会经济需求较高的 HPSA 人群有益。需要进一步研究如何优化 NP 劳动力，以满足服务不足地区不断增长的初级保健需求。
