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. 2019 Jan 1;321(1):102-105.
doi: 10.1001/jama.2018.17944.

Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 2010-2016

Ying Xue  1 , Joyce A Smith  1 , Joanne Spetz  2
Affiliations

Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 2010-2016

Ying Xue et al. JAMA. .

Abstract

This study analyzes trends in the distribution of nurse practitioners and primary care physicians in low-income and rural areas.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Xue reported receiving personal fees from the National Council of State Boards of Nursing. Dr Spetz reported receiving grants from the Health Resources and Services Administration, Robert Wood Johnson Foundation, Public Health Institute, Kaiser Foundation Health Plan, Health Care Cost Institute, University of Washington, and California Health Care Foundation and personal fees from the American Organization for Nurse Executives, Massachusetts General Hospital/Partners Healthcare, AARP Center to Champion Nursing in America, Westat/Assistant Secretary for Planning and Evaluation, and California Board of Registered Nursing. No other disclosures were reported.

Figures

Figure.
Figure.. Trends in the Geographic Distribution of Primary Care Nurse Practitioner (NP) and Primary Care Physician Supply, 2010-2016
Data on primary care NPs (primary care, adult, family, general gerontology, and general pediatrics, and had an active registration number for full study year) from the National Provider Identifier registry. Data on primary care physicians (nonfederal employees, provided patient care, and held either a doctor of medicine or a doctor of osteopathy degree in general family medicine, general practice, general internal medicine, or general pediatrics) from the American Medical Association Physician Masterfile. The error bars represent 95% CIs. aIncome quartile defined by proportion of the population with an income level ≤138% of the federal poverty level ($16 394 for a household with 1 individual per year in 2016). The median household income in 2016 was $64 314 for Q1; $52 270 for Q2; $47 227 for Q3; and $39 109 for Q4. bPopulation density based on the 2013 US Department of Agriculture Rural-Urban Continuum Codes (metropolitan health service area [HSA] included ≥1 metropolitan county; urban HSA, ≥1 urban county with population >2500; and rural HSA, completely rural status or with population <2500).
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References

    1. US Department of Health and Human Services National and regional projections of supply and demand for primary care practitioners: 2013-2025. https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/r.... Accessed September 10, 2018.
    1. US Department of Health and Human Services Area Health Resources File: 2017-2018. https://data.hrsa.gov/topics/health-workforce/ahrf. Accessed September 10, 2018.
    1. Centers for Medicare & Medicaid Services National Provider Identifier registry: 2017. https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplificati.... Accessed May 9, 2017.
    1. Auerbach DI, Staiger DO, Buerhaus PI. Growing ranks of advanced practice clinicians—implications for the physician workforce. N Engl J Med. 2018;378(25):2358-2360. doi:10.1056/NEJMp1801869 - DOI - PubMed
    1. US Department of Health and Human Services Highlights from the 2012 national sample survey of nurse practitioners. https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/npsurveyhighlights.pdf. Accessed September 10, 2018.

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