title: Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients.
abstract: Strengthening health care overall is essential to the health of our nation and promoting access to health care as well as controlling health care costs in a quality cost-effective manner. Nurse practitioners have demonstrated to be effective and cost-effective providers in prior research; however, many states restrict their practice. We examined for a statistically significant relationship between the level of advanced practice registered nurse (APRN) practice (full, reduced, or restricted) allowed and results of recent nationwide, state level analyses of Medicare or Medicare-Medicaid beneficiaries of potentially avoidable hospitalizations, readmission rates after inpatient rehabilitation, and nursing home resident hospitalizations and then compared them with state health outcome rankings. States with full practice of nurse practitioners have lower hospitalization rates in all examined groups and improved health outcomes in their communities. Results indicate that obstacles to full scope of APRN practice have the potential to negatively impact our nation's health. Action should be taken to remove barriers to APRN practice.
authors.affiliation: University of Missouri, Sinclair School of Nursing, Columbia, MO.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Oliver
authors.affiliation: University of Missouri, Sinclair School of Nursing, Columbia, MO.
authors.forename: Lila
authors.initials: L
authors.lastname: Pennington
authors.affiliation: Boone Internal Medicine Associates, Columbia, MO.
authors.forename: Sara
authors.initials: S
authors.lastname: Revelle
authors.affiliation: University of Missouri, Sinclair School of Nursing, Columbia, MO. Electronic address: Rantz@missouri.edu.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Rantz
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D009722:Nurse Practitioners / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States
keywords: Medicaid; Medicare; Nurse practitioners