JAMA Health Forum
February 2024
Importance: Health care delivery systems rely on a well-prepared and adequately sized registered nurse (RN) workforce. The US RN workforce decreased by more than 100 000 in 2021 during the COVID-19 pandemic-a far greater single-year drop than observed over the past 4 decades. The implication for the longer-term growth of the RN workforce is unknown.
View Article and Find Full Text PDFThis keynote paper is the first installment in the six-part Nursing Outlook special edition based on the 2022 Emory University Business Case for Nursing Summit. The summit, which took place in March 2022, was led by Emory School of Nursing in partnership with Emory School of Business. It convened national nursing, health care, and business leaders to explore possible solutions to nursing workforce crises.
View Article and Find Full Text PDFImportance: A better understanding of the association between family structure and sex gaps in physician earnings and hours worked over the life cycle is needed to advance policies addressing persistent sex disparities.
Objective: To investigate differences in earnings and hours worked for male and female physicians at various ages and family status.
Design, Setting, And Participants: This retrospective, cross-sectional study used data on physicians aged 25 to 64 years responding to the American Community Survey between 2005 and 2019.
With the ongoing transition to value-based health care, a strong command of foundational economic concepts, like cost and value, and the ability to thoughtfully engage in value-informed nursing practice have become essential for the future of the nursing profession. Earlier in this six-part series, we explained value-informed nursing practice, its historical, economic, and ethical foundation, its promise for an environmentally responsible, innovation-driven future health care, and why its adoption requires a reframing of some of the nursing's professional norms and behaviors. This paper concludes the series with one of the most important issues-education for value-informed nursing practice.
View Article and Find Full Text PDFPurpose: Rural registered nurses (RNs) play an integral role in providing care for an underserved population with worse health outcomes than urban counterparts. However, little information is available on the profile of this workforce, which is necessary to understand the capacity of these nurses to provide quality and demanded care presently and in the future.
Methods: We utilize data from the American Community Survey to provide a contemporary analysis on the supply of rural RNs in the United States.
With the adoption of value-based payments which tie reimbursement to patient outcomes and costs, days when nursing is viewed primarily as a cost to hospitals will soon be over. Already the backbone of high-quality care delivery and patient outcomes, nurses are becoming key drivers of health care organizations' financial outcomes, too. The first three articles published in this 6-part series on value-informed nursing practice-practice that considers both the outcomes and the cost of producing the outcomes-described what value-informed nursing practice means, its economic, policy, and ethical impetuses, and how value-informed nursing practice helps improve environmental sustainability of health systems.
View Article and Find Full Text PDFIn this 3rd part of our 6-part series on value-informed nursing practice-practice that focuses on both achieving desired patient outcomes and minimizing the use of costly resources to achieve these outcomes-we focus on the importance of nurses in improving environmental outcomes and reducing costly environmental waste. We also propose how nursing education needs to change to prepare the next generation of nurses to effectively address environmental problems through providing value-informed nursing practice.
View Article and Find Full Text PDFBackground: Policymakers are increasingly interested in using nurse practitioners to provide health care to rural populations, yet little is known about their characteristics and preparation for independent practice.
Methods: We obtained data from the 2018 National Sample Survey of Registered Nurses and compared characteristics of family nurse practitioners (FNPs) employed in rural areas versus those employed in non-rural areas. Regression analysis was used to determine the relationship between the outcome variable of interest, preparation for practice and other covariates.
Nurses make decisions about the use of costly resources in countless care delivery settings 24 hours a day. Consequently, nurses are inseparably connected to not only the quality and safety of care, but to the cost-of-care as well. This article is Part 1 of a 6-part series on value-informed nursing practice.
View Article and Find Full Text PDFHealth Aff (Millwood)
January 2022
Analysis of Current Population Survey data suggests a tightening labor market for registered nurses, licensed practical nurses, and nursing assistants, marked by falling employment and rising wages through June 2021. Unemployment rates remain higher in nonhospital settings and among registered nurses and nursing assistants who are members of racial and ethnic minority groups.
View Article and Find Full Text PDFDifferent staffing configurations in primary and geriatric care practices could have implications for how best to deliver services that are essential for a growing population of older adults. Using data from a 2018 survey of physicians (MDs) and nurse practitioners (NPs) working in primary and geriatric care, we assessed whether different configurations were associated with better or worse performance on a number of standard process measures indicative of comprehensive, high-quality primary care. Practices with a large concentration of MDs had the highest estimated labor costs.
View Article and Find Full Text PDFBackground: Population aging and physician shortages have motivated recommendations of increased use of registered nurses in care provision; little is known about RN and NP employment in primary care and geriatric practices or service types each provide.
Purpose: Determine current RN and NP employment frequency in practices in the U.S.
Background: The U.S. health care system faces increasing pressures for reform.
View Article and Find Full Text PDFBackground: Although recent research suggests that primary care provided by nurse practitioners costs less than primary care provided by physicians, little is known about underlying drivers of these cost differences.
Research Objective: Identify the drivers of cost differences between Medicare beneficiaries attributed to primary care nurse practitioners (PCNPs) and primary care physicians (PCMDs).
Study Design: Cross-sectional cost decomposition analysis using 2009-2010 Medicare administrative claims for beneficiaries attributed to PCNPs and PCMDs with risk stratification to control for beneficiary severity.