The Impact of Nurse Practitioner Autonomy on Patient Sorting and Health Outcomes

• In Event: Comparative Insights on Care Provision, Access, and Costs in Aging and Chronic Illness

Abstract

States have expanded nurse practitioners' (NPs) autonomy from physician oversight to increase access to care, but this raises concerns about health outcomes under independent practice. I study how patients sort between NPs and physicians as primary care providers when NPs gain full practice authority, using state-level changes in NP scope of practice and data from the Medical Expenditure Panel Survey. I find that when NPs can practice independently of physicians, patients with multiple chronic conditions visit NPs more than physicians, and diagnoses of common chronic diseases increase. However, self-reported health declines, and evidence suggests limited adherence to antibiotic prescribing guidelines by NPs following the policy change. These results suggest that full NP practice authority enhances utilization of care among higher-risk patients and increases detection of chronic diseases, but improvements in overall health are limited.

Author

• Sooa Ahn, The Ohio State University
  Presenting Author