Turi Eleanor, McMenamin Amy L, Courtwright Suzanne, Martsolf Grant, Liu Jianfang, Hasin Deborah, Poghosyan Lusine
University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, 19104.
Columbia University School of Nursing, 560 W 168 Street, New York, NY, 10032.
J Nurse Pract. 2024 Oct;20(9). doi: 10.1016/j.nurpra.2024.105152. Epub 2024 Jul 20.
We examined the relationship between the nurse practitioner (NP) work environment and realized access (i.e., utilization) to primary care among rural older adults with substance use disorders (SUD). We analyzed cross-sectional NP survey data merged with Medicare claims and utilized fractional logistic regression. With one unit improvement in NP work environment, the odds of having older adults with SUDs in the practice increased by 20% (adjusted odds ratio=1.20, 95% confidence interval=1.01-1.44, p=0.04). Favorable work environments for NPs, including organizational support, collegiality, and role visibility, are associated with increased realized access to primary care among rural older adults with SUDs.
我们研究了执业护士（NP）的工作环境与患有物质使用障碍（SUD）的农村老年人获得初级保健服务（即利用率）之间的关系。我们分析了与医疗保险理赔数据合并的NP横断面调查数据，并采用了分数逻辑回归分析。随着NP工作环境改善一个单位，在该医疗机构中患有SUD的老年人就诊的几率增加了20%（调整后的优势比=1.20，95%置信区间=1.01-1.44，p=0.04）。对NP而言，有利的工作环境，包括组织支持、同事关系和角色可见性，与患有SUD的农村老年人获得更多初级保健服务相关。
