State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review

Bo Kyum Yang; Mary E. Johantgen; Alison M. Trinkoff; Shannon R. Idzik; Jessica Wince; Carissa Tomlinson

doi:10.1177/1077558719901216

State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review

Bo Kyum Yang, Mary E. Johantgen, Alison M. Trinkoff, Shannon R. Idzik, Jessica Wince, Carissa Tomlinson

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Abstract

There is a great variation across states in nurse practitioner (NP) scope of practice moderated by state regulations. The purpose of this study was to synthesize the evidence from studies of the impact of state NP practice regulations on U.S. health care delivery outcomes (e.g., health care workforce, access to care, utilization, care quality, or cost of care), guided by Donabedian’s structure, process, and outcomes framework. This systematic review was performed using Medline, CINAHL, PsycINFO, and PubMed according to Preferred Reporting Items for Systematic and Meta-Analysis on the literature from January 2000 to August 2019. The results indicate that expanded state NP practice regulations were associated with greater NP supply and improved access to care among rural and underserved populations without decreasing care quality. This evidence could provide guidance for policy makers in states with more restrictive NP practice regulations when they consider granting greater practice independence to NPs.

Original language	English (US)
Pages (from-to)	183-196
Number of pages	14
Journal	Medical Care Research and Review
Volume	78
Issue number	3
DOIs	https://doi.org/10.1177/1077558719901216
State	Published - Jun 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by Summer Undergraduate Research Institute at Towson University.

Funding Information:
We thank Christelle Mbah, an undergraduate student at Towson University for assistance with literature search and review, and Dr. Ying Xue at the University of Rochester School of Nursing for comments that greatly improved the article. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by Summer Undergraduate Research Institute at Towson University.

Publisher Copyright:
© The Author(s) 2020.

Keywords

access to care
and workforce
health care cost
health care utilization
nurse practitioners
practice regulations
quality of care

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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