Comparison of Rural and Urban Utilization of Nurse Practitioners in States With Full Practice Authority

Abstract Full practice authority (FPA) has been enacted for nurse practitioners in 23 states and Washington, DC, to combat provider shortages and improve access of care. No studies have investigated the utilization of NPs after the legislative change. The aim of this study is to describe the utilization of NPs in states with FPA using 4 components of utilization (ie, billing, privileges, supervision, and prescriptive authority) and to examine differences in utilization between rural and urban areas. A cross-sectional, descriptive, correlational design was used. Urban NPs were more likely to work in specialties and have restrictions on their privileges. Rural NPs tended to work in primary care and were less likely to have restrictions on their practice. Substantial barriers remain to FPA at the health care system level despite state legislation. Differences in utilization between rural and urban areas are evident. To ensure access to quality health care, NPs need to be used to their full scope.