Contextual Correlates of Rural Health Clinics' Efficiency: Analysis of Nurse Practitioners' Contributions

Judith Ortiz, PhD, MBA; Thomas T.H. Wan, PhD; Natthani Meemon, MA; Seung Chun Paek, MS; Abiy Agiro, MHS


Nurs Econ. 2010;28(4):237-244. 

In This Article

Abstarct and Introduction


Rural Health Clinics (RHCS) play an important role in the delivery of health services to medically underserved areas in the United States. In RHCs throughout the nation, nurse practitioners (NPs) fill key leadership positions. RHCs are as varied as clinics in urban areas. They differ in size, ownership, system membership, years of operation, and other organizational characteristics. However, little research has been conducted to identify the variability in their performance. National studies on factors influencing the efficiency and effectiveness of RHCs are scarce or nonexistent. The availability of administrative data sets from Health Resources and Services Administration and the Centers for Medicare and Medicaid Services enables us to ascertain and summarize the total configuration and operation of these clinics. The purpose of this research was to examine the relative contribution of NPs to RHCs' productivity, determine the interrelationship of efficiency indicators of RHCs, and identify contextual and structural factors that influence the variation in efficiency.