Effects of State Scope of Practice Laws on Supply of Nurse Practitioners in Rural Communities

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dc.contributor.advisorMaddox, Peggy J
dc.creatorJones, Tammie Michele
dc.date.accessioned2023-04-10T18:46:32Z
dc.date.issued2022
dc.description.abstractIn 1965, the nurse practitioner profession began in response to a shortage of primary care providers in urban and rural areas. States began recognizing advanced practice nurse providers who completed certificate or post graduate training programs for advanced practice to diagnose and treat health conditions under various levels of physician supervision. Today, over 25 million people live in areas designated as rural primary care health professional shortage areas where it is still difficult to get timely access to health services. The National Governor’s Association, advocates for nurse practitioners, and researchers have suggested that more effective incorporation of nurse practitioner services and easing restrictions to practice could mitigate the growing shortage and/or maldistribution of primary care physicians, reduce geographic disparities, and improve access to primary care services. Over time, some states have amended their nurse practice acts to allow nurse practitioners more independent practice with the intent to increase the supply of primary care providers and improve access to care (especially in rural and underserved areas). Research studies conducted to date provide limited understanding about the relationship between state nurse practice act changes on the growth and distribution in the supply of nurse practitioners as primary care providers. This dissertation employed a difference-in-differences design to exploit variation in timing of changes in state scope of practice laws (from more restrictive to less restrictive) to study the causal effects on the supply of nurse practitioners at the county level. The results of this study found states that authorized nurse practitioners to practice independently saw a 17.5 percent decrease in the number of nurse practitioners at the county level and a 12.5 percent decrease in rural counties. We found the supply of nurse practitioners continued to decline 7 years after adoption of full scope of practice regulation in two states.
dc.description.embargo2024-08-31
dc.description.noteThis work is embargoed by the author and will not be publicly available until 2024-08-31.
dc.format.extent68 pages
dc.format.mediumdoctoral dissertations
dc.identifier.urihttps://hdl.handle.net/1920/13257
dc.language.isoen
dc.rightsCopyright 2022 Tammie Michele Jones
dc.rights.urihttps://rightsstatements.org/vocab/InC/1.0
dc.subjectAccess to cares
dc.subjectHealth workforce
dc.subjectNurse practitioner
dc.subjectScope of practice
dc.subjectSupply
dc.subject.keywordsNursing
dc.subject.keywordsLabor economics
dc.subject.keywordsHealth care management
dc.titleEffects of State Scope of Practice Laws on Supply of Nurse Practitioners in Rural Communities
dc.typeText
thesis.degree.disciplineHealth Services Research
thesis.degree.grantorGeorge Mason University
thesis.degree.levelDoctoral
thesis.degree.namePh.D. in Health Services Research

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