COMMENTARY

Nurse Practitioner Practice: Full Scope, Better Outcomes

Tom G. Bartol, NP

Disclosures

October 08, 2014

In This Article

Study Findings

Statistically significant improved outcomes were found in all 4 areas in states with full practice (n=17) compared with states without full practice (n=33). Potentially avoidable hospitalizations for Medicare and Medicaid beneficiaries were 100/1000 person-years in the full practice states compared with 146/1000 person-years in the states without full practice. Thirty-day hospital readmissions after discharge from rehabilitation were 10.46 in the full practice group and 11.68 in the states without full practice. Annual hospitalization of nursing home patients averaged 18.1 in full-practice states vs. 25.9 in states without full practice. Overall health outcomes (with lower numbers corresponding to better outcomes) averaged 17 in the full-practice states and 30 in the states without full practice.

When compared individually with either reduced or restricted practice, full-practice states had statistically significantly better outcomes in all 4 areas compared with either of the limited practice states.

The investigators point out that these are associations and that causality cannot be confirmed, but these outcomes should be examined closely and should be an impetus for further changes in public policy to ensure that NPs have full practice across the country.

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