Nurse practitioners' workforce outcomes under implementation of full practice authority

Nurs Outlook. 2020 Jul-Aug;68(4):459-467. doi: 10.1016/j.outlook.2020.05.008. Epub 2020 Jun 24.

Abstract

Background: Full practice authority laws that permit nurse practitioners (NPs) to practice independently and prescribe medications may influence NPs' workforce outcomes.

Purpose: To examine whether implementation of full practice authority laws affect NP self-employment, average earnings, and likelihood of residing in a primary care health professional shortage area (HPSA).

Methods: A nationally representative U.S. sample of 9,782 NPs employed in health care during 2010 to 2018 was drawn from the American Community Survey. Difference-in-differences regression was used to estimate covariate-adjusted mean differences in NPs' workforce outcomes after full practice authority implementation.

Findings: Among full-time employed NPs, full practice authority was associated with an increased probability of residing in a HPSA (adjusted odds ratio [aOR]:2.34, 95%CI 1.14, 4.83) and with a higher mean probability of self-employment (aOR:4.97, 95%CI 1.00, 24.86).

Discussion: Full practice authority implementation improves access to primary care providers in health professional shortage areas and may increase practice ownership among NPs.

Keywords: American Community Survey; Self-employment; difference-in-differences; earnings; health professional shortage areas.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurse Practitioners / standards*
  • Nurse Practitioners / statistics & numerical data*
  • Professional Autonomy*
  • Professional Competence / standards*
  • Professional Competence / statistics & numerical data*
  • Professional Role*
  • United States
  • Workforce / statistics & numerical data*