Autonomie des infirmières praticiennes: quels effets sur les soins, ainsi que sur les patients et les patientes?

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Le Département d’opérations et systèmes de décision vous invite à une présentation de la doctorante Sooa Ah sur sa recherche The Impact of Nurse Practitioner Autonomy in Patient Sorting and Health Outcomes. Café et viennoiseries seront offertes sur place.

La présentation se déroulera en anglais.

Résumé

The Impact of Nurse Practitioner Autonomy in Patient Sorting and Health Outcomes.

Healthcare systems increasingly rely on nurse practitioners (NPs) to expand access to care, as they can diagnose illnesses, prescribe medications, and provide primary care services. Because their training differs from physicians, many states historically limited their scope of practice through physician oversight. In recent years, several states have granted NPs full practice authority. Existing research suggests that removing supervision increases care utilization but produces only modest improvements in health outcomes. This study examines how granting NPs full practice authority affects patient sorting between NPs and physicians and explores why improvements in health outcomes remain limited. Fourteen state-level policy expansions in the United States between 2010 and 2019 are analyzed using patient-visit data from the Medical Expenditure Panel Survey with an event-study design. Results indicate that higher-risk patients visit NPs more frequently after the reforms, particularly for mental health care. NP autonomy also leads to increased diagnoses of common chronic conditions and greater prescription use. However, changes in health outcomes are small and not clinically meaningful, while emergency room use increases among high-risk patients. Overall, expanded NP autonomy increases healthcare utilization but produces limited improvements in measured health outcomes.