Nurse Practitioner Independent Practice Authority and Mental Health Service Delivery in US Community Health Centers

被引：24

作者：

Yang, Bo Kyum ^{[1
]}

Trinkoff, Alison M. ^{[1
]}

Zito, Julie Magno ^{[3
,4
]}

Burcu, Mehmet ^{[3
]}

Safer, Daniel J. ^{[5
,6
]}

Storr, Carla L. ^{[1
,2
]}

Johantgen, Mary E. ^{[1
]}

Idzik, Shannon ^{[1
]}

机构：

[1] Univ Maryland, Sch Nursing, Baltimore, MD 21201 USA

[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA

[3] Univ Maryland, Dept Pharmaceut Hlth Serv Res, Baltimore, MD 21201 USA

[4] Univ Maryland, Dept Psychiat, Baltimore, MD USA

[5] Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21205 USA

[6] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA

来源：

PSYCHIATRIC SERVICES | 2017年 / 68卷 / 10期

关键词：

PRIMARY-CARE-WORKFORCE; SCOPE-OF-PRACTICE; PHYSICIAN ASSISTANTS; UNITED-STATES; REGULATIONS; PATTERNS; TRENDS; APNS;

D O I：

10.1176/appi.ps.201600495

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs). Methods: State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP-and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA. The adjusted odds of mental health-related visits in CHCs provided by NPs in states with and without NP-IPA were compared by using multiple logistic regression models while accounting for the complex survey design. Results: Between 2006 and 2011, the odds of NP-versus physician-provided mental health-related visits in CHCs were more than two times greater in states with NP-IPA than in states with no NP-IPA (adjusted odds ratio [ OR]=2.43, 95% confidence interval [CI]=1.12-4.60). In contrast, no significant difference between states with and without NP-IPA was noted in non-mental health-related CHC visits provided by NPs. Among all mental health-related visits, the odds of visits in which psychotropic medications were prescribed by an NP were more than three times higher in states with NP-IPA than in those without NP-IPA (adjusted OR=3.14, CI=1.50-6.54). Conclusions: Compared with physicians, NPs provided proportionally more CHC mental health-related visits in states with NP-IPA than in states without NP-IPA.

引用

页码：1032 / 1038

页数：7

共 37 条

[1]

[Anonymous], 2016, STAFF SAF NET BUILD

[2]

[Anonymous], 2009, 2009 ROL DEL STUD CL

[3]

[Anonymous], 2016, QUEST DAT REL DOC DO

[4]

[Anonymous], 2016, AMB HLTH CAR DAT WHA