ArticleHealth services research2017
Does the Regulatory Environment Affect Nurse Practitioners' Patterns of Practice or Quality of Care in Health Centers?
Article in Health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Design, delivery and effectiveness of health practitioner regulation systems: an integrative review.Human resources for health · 2023Pooled it
- Does State-Level Nurse Practitioner Scope-of-Practice Policy Affect Access to Care?Western journal of nursing research · 2019Pooled it
- The Scope of Care Coordination for Older Adults Whose Dominant Provider Is a Nurse Practitioner Versus a Primary Care Physician.Medical care · 2026Article
- Job preference of nurse practitioners: A simulation approach.International journal of nursing studies advances · 2025Article
- State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019.Health affairs scholar · 2024Article
- Opioid Use Disorder Practice by Licensure Category in North Carolina.North Carolina medical journal · 2023Article
- State-level scope of practice regulations for nurse practitioners impact work environments: Six state investigation.Research in nursing & health · 2022Article
- Supportive Practice Environments Are Associated With Higher Quality Ratings Among Nurse Practitioners Working in Underserved Areas.Journal of nursing regulation · 2022Article
- Scope-of-Practice for Nurse Practitioners and Adherence to Medications for Chronic Illness in Primary Care.Journal of general internal medicine · 2021Article
- Optimal staffing in community health centers to improve quality of care.Health services research · 2021Article
- Advanced practice nursing: Qualitative study of implications for family physicians' perceptions of their own work.Canadian family physician Medecin de famille canadien · 2019Article
- Regulation of the Nurse Practitioner Workforce: Implications for Care Across Settings.Journal of nursing regulation · 2019Article
- Cardiovascular Risk Factors and Provision of Lifestyle Counseling for Diabetes or Prediabetes With Comorbid Obesity: Analysis of Office-Based Physician Visits Made by Patients 20 Years of Age or Older.Diabetes spectrum : a publication of the American Diabetes Association · 2019Article
- Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.Health services research · 2018Article
- Key nodes affecting patient satisfaction in a cross-regional referral service process: an empirical analysis study in Sichuan.BMC health services research · 2018Article
- Impact of Nurse Practitioner Practice Regulations on Rural Population Health Outcomes.Healthcare (Basel, Switzerland) · 2018Article
- The Epicenter of Effectiveness and Efficiency in Health Care Delivery: The Evolving U.S. Health Workforce.Health services research · 2017Article
- Factors Associated With Having a Physician, Nurse Practitioner, or Physician Assistant as Primary Care Provider for Veterans With Diabetes Mellitus.Inquiry : a journal of medical care organization, provision and financing · 2017Article
- The Impact of Nurse Practitioner-Led Primary Care on Quality and Cost for Medicaid-Enrolled Patients in States With Pay Parity.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the impact of state-granted nurse practitioner (NP) independence on patient-level quality, service utilization, and referrals. DATA SOURCES/STUDY
settingThe National Ambulatory Medical Care Survey's community health center (HC) subsample (2006-2011). Primary analyses included approximately 6,500 patient visits to 350 NPs in 220 HCs. STUDY
designPropensity score matching and multivariate regression analysis were used to estimate the impact of state-granted NP independence on each outcome, separately. Estimates were adjusted for sampling weights and NAMCS's complex design. DATA COLLECTION/EXTRACTION
methodsEvery "NP-patient visit unit" was isolated using practitioner and patient visit codes and, using geographic identifiers, assigned to its state-year and that state-year's level of NP independence based on scope of practice policies. Nine outcomes were specified using ICD-9 codes, standardized drug classification codes, and NAMCS survey items. PRINCIPAL
findingsAfter matching, no statistically significant differences in quality were detected by states' independence status, although NP visits in states with prescriptive independence received more educational services (aIRR 1.66; 95 percent CI 1.09-2.53; p = .02) and medications (aIRR 1.26; 95 percent CI 1.04-1.53; p = .02), and NP visits in states with practice independence had a higher odds of receiving physician referrals (AOR 1.88; 95 percent CI 1.10-3.22; p = .02) than those in restricted states.
conclusionsFindings do not support a quality-scope of practice relationship.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.