Shi L, Samuels M E
Department of Health Administration, School of Public Health, University of South Carolina, Columbia 29208, USA.
J Allied Health. 1997 Summer;26(3):105-11.
This report examines the relation between state variations in the regulation of nurse practitioners (NPs), physician assistants (PAs), and certified nurse midwives (CNMs), and the employment of these nonphysician providers (NPPs) by community health centers (CHCs). Data for this report came from a 1991-92 survey of CHCs assessing the employment of NPPs, and secondary available data. The dependent variables examined were the numbers of NPPs currently employed by CHCs. Independent variables included 1992 practice environment scores, CHC location, number of CHC physicians, and NPP-to-population ratios. The number of NPs and PAs employed by CHCs was significantly associated with practice environment for these practitioners. NPP-to-population ratios and the number of CHC physicians are also significantly associated with NPP employment by CHCs. State decision makers may reduce legislative and regulatory barriers to practice as a way to improve the practice environment for nonphysician primary care providers, particularly NPs and PAs. Thus, community health centers can employ adequate number of NPPs to fulfill their mission of serving the poor and underserved population.
本报告探讨了各州在执业护士（NPs）、医师助理（PAs）和认证助产士（CNMs）监管方面的差异，以及社区卫生中心（CHCs）对这些非医师医疗服务提供者（NPPs）的聘用情况。本报告的数据来自1991 - 1992年对社区卫生中心进行的一项关于评估非医师医疗服务提供者聘用情况的调查，以及其他可得的二手数据。所考察的因变量是社区卫生中心目前聘用的非医师医疗服务提供者的数量。自变量包括1992年的执业环境得分、社区卫生中心的位置、社区卫生中心的医师数量以及非医师医疗服务提供者与人口的比例。社区卫生中心聘用的执业护士和医师助理的数量与这些从业者的执业环境显著相关。非医师医疗服务提供者与人口的比例以及社区卫生中心的医师数量也与社区卫生中心聘用非医师医疗服务提供者显著相关。州决策者可以减少执业的立法和监管障碍，以此改善非医师初级保健提供者，特别是执业护士和医师助理的执业环境。因此，社区卫生中心能够聘用足够数量的非医师医疗服务提供者来履行其为贫困和服务不足人群服务的使命。
