Abstract
Nurse practitioners have become an increasingly important part of the US medical workforce as they have gained greater practice authority through state-level regulatory changes. This study investigates one labor market impact of this large change in nurse practitioner regulation. Using data from the National Sample Survey of Registered Nurses and a dataset of state-level nurse practitioner prescribing authority, a multivariate estimation is performed analysing the impact of greater practice authority on the probability of a nurse practitioner moving from a state. The empirical results indicate that nurse practitioners in states that grant expanded practice are less likely to move from the state than nurse practitioners in states that have not granted expanded practice authority. The estimated effect is robust and is statistically and economically meaningful. This finding is in concert with and strengthens the wider literature which finds states that grant expanded practice authority to nurse practitioners tend to have larger nurse practitioner populations.
Highlights
Nurse practitioners (NPs) are, according to the International Council of Nurses, “a registered nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” [1]
The interpretation of the marginal effect coefficient is the change in the probability of a move for an NP with the sample mean characteristics if there is a one unit change the independent variable in question
The core finding is that an NP in a state that has granted expanded practice authority as measured through controlled substance prescriptive authority is less likely to move than if the state had not granted such authority
Summary
Nurse practitioners (NPs) are, according to the International Council of Nurses, “a registered nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice” [1]. In the United States, NPs are typically masters-prepared registered nurses and have become an increasingly important part of the health care system. They have over time obtained greater practice authority through state-level regulatory changes which has fundamentally altered what an NP can do as a caregiver. In most U.S states, NPs can see, diagnose, prescribe, and in general provide care for patients as a general practice physician would. As such, these regulatory changes in practice authority, and the “rise” of the NP they have ushered in, have fundamentally changed the NP labor market
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