Nurse practitioners: a comparison of rural-urban practice patterns and willingness to serve in underserved areas.
OBJECTIVE
To determine nurse practitioners' (NPs) practice patterns and willingness to practice in underserved areas in both rural and urban settings in a largely rural state.


METHODS
A census of all NPs holding a Pennsylvania license and providing addresses in Pennsylvania or one of the contiguous states was conducted in 1996. The ZIP codes of practice sites were matched with 1990 census data.


CONCLUSIONS
Nurse practitioners in rural areas are more likely than their urban counterparts to provide primary care in primary care practice settings, they see more patients per week, and they are more likely to be the principal provider of care for a higher percentage of their patients. Experience with managed care contracts is greater for urban NPs as is their willingness to practice in urban underserved areas. Rural NPs were more willing to practice in rural underserved areas than their urban counterparts.


CONCLUSIONS
Access to primary care continues to be a concern in rural areas. The increasing market penetration of managed care and the deficit of primary care providers in rural environments may lead to increased opportunities for NPs in the rural health care delivery system.
Martin
K E
KE
Center for Community, Economic and Workforce Development, West Virginia University Extension Service, USA. kmarti15@wvu.edu
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008507:Medically Underserved Area; D008875:Middle Aged; D009722:Nurse Practitioners; D011320:Primary Health Care; D019035:Rural Health Services; D019037:Urban Health Services; D000078329:Workforce