Nurse Practitioner and Physician Assistant Satellite Health Centers

Brooks, Edward F.; Johnson, Susan L.

doi:10.1097/00005650-198610000-00002

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…Our study found that 52% of the nurse practitioners were located in large urban centers with the highest inner city populations. The current distribution of nurse practitioners is consistent with the Office of Technology Assessment's expectation (1986) and an early longitudinal study by Brooks and Johnson (1986), that is, a greater concentration of nurse practitioners in urban areas and a lower concentration in rural areas. However, this pattern cannot be associated with increased competition from primary-care physicians, as was suggested by the Office of Technology Assessment.…”

Section: Conclusion and Discussionsupporting

confidence: 84%

“…However, as nurse practitioners grow in number, their distribution moves increasingly toward urban areas (Office of Technology Assessment, 1986). In a national study of 44 rural satellite health centers, Brooks and his colleagues (Brooks et al, 1981;Brooks and Johnson, 1986) found that the number of nurse practitioners had declined 38% between 1975 and 1984. Although the Office of Technology Assessment (1986) speculated that this trend would continue into the early 1990s as a result of increased supply of primary-care physicians in rural areas, no one has examined this issue.…”

Section: Introductionmentioning

confidence: 99%

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The geographic distribution of nurse practitioners in the United States

Lin,

Burns,

Nochajski

1997

Appl. Geogr. Studies

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This study analyzed the geographic distribution of nurse practitioners in the United States. Primary data on nurse practitioners were obtained from State Boards of Nursing and the District of Columbia in the spring of 1994. At the state level, nurse practitioners were more concentrated in urban areas than their physician counterparts. Of the 33,094 certified nurse practitioners, 85% were in metropolitan areas. Results from the dissimilarity indices between nurse practitioners and general populations showed that a greater supply of nurse practitioners in a state may not necessarily lead to an equitable distribution across counties. At both the state and county levels, the supply of nurse practitioners was positively associated with the supply of primary care physicians. Results from multivariate analyses show that nurse practitioners were more likely to locate in a county where state laws allowed independent practice. States that allow independent practice and direct third-party reimbursement will likely have greater availability and a larger supply of nurse practitioners in rural counties.

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Section: Conclusion and Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The geographic distribution of nurse practitioners in the United States

Lin,

Burns,

Nochajski

1997

Appl. Geogr. Studies

View full text Add to dashboard Cite

show abstract

“…While financing mechanisms are an important factor, the success of practitioners in developing alternative forms of practice depends on many variables. Brooks and Johnson (1986) studied 44 rural satellite health centers originally staffed by NPs and PAS in 1974,1979 in order to assess the viability of this type of clinic when physician shortage was less of a problem. Although the study was limited to 44 settings, their findings suggest that centers staffed by physicians are more organizationally stable than those with only a NP or PA.…”

Section: Rural Health Clinics Passage Of the Federal Rural Health CLmentioning

confidence: 99%

Financing Rural Health and Medical Services*

Straub¹

1990

The Journal of Rural Health

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The provision and utilization of health care services in rural areas are tied directly to the structure of financing. The model of rural health care shaped by federal policies over three decades was significantly altered by changes during the 1980s. With reactions of third-party payers to health care costs rising faster than inflation, the difficulty of accommodating access to care and cost efficiency in provision became evident. This review begins with the literature on patient services and capital financing of rural hospitals, then continues with the financing of clinics, community centers, and other supply forms. Research during the 1980s provides insight into the effects of various financing policies on the supply of services. The demand for health care in rural areas is characterized by less generous third-party coverage, leaving residents paying a larger share of their incomes for care than do urban residents. As a consequence, access to care is especially difficult for low-income and elderly people, heavily dependent upon government financing. Third-party payers have severely reduced cost shifting as a mechanism for taking care of the health care needs of a sizable share of the population, thereby placing providers in an uncomfortable position. Several potential and more formalized financing options for replacing cost shifting are discussed. Several important changes will take place with rural-focused legislation enacted in the late 1980s. These are used to present a rural financing research agenda for the 1990s.

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“…However, as nurse practitioners grow in number, their distribution moves increasingly toward urban areas (Office of Technology Assessment, 1986). In a national study of 44 rural satellite health centers, Brooks and his colleagues (Brooks et al, 1981;Brooks and Johnson, 1986) found that the number of nurse practitioners had declined 38% between 1975and 1984. Although the Office of Technology Assessment (1986 speculated that this trend would continue into the early 1990s as a result of increased supply of primary-care physicians in rural areas, no one has examined this issue.…”

Section: Introductionmentioning

confidence: 99%

The geographic distribution of nurse practitioners in the United States

Lin

Burns

Nochajski³

1997

Appl. Geogr. Studies

View full text Add to dashboard Cite

This study analyzed the geographic distribution of nurse practitioners in the United States. Primary data on nurse practitioners were obtained from State Boards of Nursing and the District of Columbia in the spring of 1994. At the state level, nurse practitioners were more concentrated in urban areas than their physician counterparts. Of the 33,094 certified nurse practitioners, 85% were in metropolitan areas. Results from the dissimilarity indices between nurse practitioners and general populations showed that a greater supply of nurse practitioners in a state may not necessarily lead to an equitable distribution across counties. At both the state and county levels, the supply of nurse practitioners was positively associated with the supply of primary care physicians. Results from multivariate analyses show that nurse practitioners were more likely to locate in a county where state laws allowed independent practice. States that allow independent practice and direct third‐party reimbursement will likely have greater availability and a larger supply of nurse practitioners in rural counties. © 1997 John Wiley & Sons, Inc.

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Nurse Practitioner and Physician Assistant Satellite Health Centers

Cited by 7 publications

References 28 publications

The geographic distribution of nurse practitioners in the United States

The geographic distribution of nurse practitioners in the United States

Financing Rural Health and Medical Services*

The geographic distribution of nurse practitioners in the United States

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