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Nurse Practitioner Independent Practice Authority and Mental Health Service Delivery in U.S. Community Health Centers.
- Source :
-
Psychiatric services (Washington, D.C.) [Psychiatr Serv] 2017 Oct 01; Vol. 68 (10), pp. 1032-1038. Date of Electronic Publication: 2017 Jun 15. - Publication Year :
- 2017
-
Abstract
- Objective: Little is known about how nurse practitioner independent practice authority (NP-IPA) influences patient care. This study examined the effect of NP-IPA on patterns of mental health-related visits provided by NPs in U.S. community health centers (CHCs).<br />Methods: State NP regulatory information was linked to National Ambulatory Medical Care Survey data on NP- and physician-provided visits (N=61,457) in CHCs from 2006 through 2011. The proportion of NP-provided versus physician-provided mental health-related visits in states with NP-IPA was compared with the proportion in states without NP-IPA. The adjusted odds of mental health-related visits in CHCs provided by NPs in states with and without NP-IPA were compared by using multiple logistic regression models while accounting for the complex survey design.<br />Results: Between 2006 and 2011, the odds of NP- versus physician-provided mental health-related visits in CHCs were more than two times greater in states with NP-IPA than in states with no NP-IPA (adjusted odds ratio [OR]= 2.43, 95% confidence interval [CI]=1.12-4.60). In contrast, no significant difference between states with and without NP-IPA was noted in non-mental health-related CHC visits provided by NPs. Among all mental health-related visits, the odds of visits in which psychotropic medications were prescribed by an NP were more than three times higher in states with NP-IPA than in those without NP-IPA (adjusted OR=3.14, CI=1.50-6.54).<br />Conclusions: Compared with physicians, NPs provided proportionally more CHC mental health-related visits in states with NP-IPA than in states without NP-IPA.
- Subjects :
- Health Care Surveys statistics & numerical data
Humans
United States
Community Health Centers statistics & numerical data
Community Mental Health Services statistics & numerical data
Delivery of Health Care statistics & numerical data
Nurse Practitioners statistics & numerical data
Physicians statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1557-9700
- Volume :
- 68
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Psychiatric services (Washington, D.C.)
- Publication Type :
- Academic Journal
- Accession number :
- 28617208
- Full Text :
- https://doi.org/10.1176/appi.ps.201600495