Revisiting the effects of state anesthesia policy interventions: A comprehensive look at certified registered nurse anesthetist service provision in U.S. hospitals from 2010 to 2021.

Aims: Rural hospitals in the United States often rely on nonphysician providers such as advanced practice nurses to care for their patients. One important role that is served by advanced practice nurses is that of anesthesia provider (certified registered nurse anesthetist or CRNA). In 2001, Centers for Medicare & Medicaid Services (CMS) passed an opt-out law affording state governors the right to loosen physician supervision requirements on CRNAs in their respective states, thus potentially improving access in targeted areas.

Advanced practice nurse case managers improve efforts by US hospitals to address patient social needs.

Aims: US hospitals are focussing more than ever on meeting important patient social needs. Patients often make multiple trips to hospitals related to nonmedical issues that could likely be averted through the increased integration of case management strategies. Although the percentage of hospitals using advanced practice nurses (APNs) in this role is still relatively low, we explore the idea that employing APN case managers improves hospitals' abilities to alleviate hospital overusage.

Differential impact of hospital and community factors on breadth and depth of hospital population health partnerships.

Objective: The aim was to identify hospital and county characteristics associated with variation in breadth and depth of hospital partnerships with a broad range of organizations to improve population health.

Data Sources: The American Hospital Association Annual Survey provided data on hospital partnerships to improve population health for the years 2017-2019.

Design: The study adopts the dimensional publicness theory and social capital framework to examine hospital and county characteristics that facilitate hospital population health partnerships.

Estimating the differences in Caesarean section (C-section) rates between public and privately insured mothers in Florida: A decomposition approach.

Background: Caesarean section (C-sections) is a medically critical and often life-saving procedure for prevention of childbirth complications. However, there are reports of its overuse, especially in women covered by private insurance as compared to public insurance. This study evaluates the difference in C-Section rates among nulliparous women in Florida hospitals across insurance groups and quantifies the contribution of maternal and hospital factors in explaining the difference in rates.

Physician dominance in the 21st century: Examining the rise of non-physician autonomy through prevailing theoretical lenses.

Theories of physician dominance are a foundational contribution of medical sociology to the study of health care, but must be revisited in the light of ongoing changes in medicine. As non-physician specialists like nurse practitioners grow in number and acquire more autonomy, increasing medical profession differentiation presents a challenge for traditional physician dominance theories. After evaluating potential theoretical explanations for subordinate occupations' autonomy gains, we conduct a state-level quantitative analysis of variation in nursing policies across U.

The Role of Organizational Slack in Buffering Financially Distressed Hospitals from Market Exits.

Financial distress is a persistent problem in U.S. hospitals, leading them to close at an alarming rate over the past two decades.

A new kind of gatekeeper: The increasing prevalence of Advanced Practice Nurses as case managers in US hospitals.

Case management is a representation of managed care, cost-containment organizational practices in healthcare, where managed care and its constitutive parts are situated against physician autonomy and decision-making. As a professional field, case management has evolved considerably, with the role recently taken up increasingly by Advanced Practice Nurses in various health care settings. We look at this evolution of a relatively new work task for Advanced Practice Nurses using a countervailing powers perspective, which allows us to move beyond discussions of case management effectiveness and best practices, and draw connections to trends in the social organization of healthcare, especially hospitals.

Seventeen states enacted executive orders expanding advanced practice nurses' scopes of practice during the first 21 days of the COVID-19 pandemic.

Context: Rural hospitals in the USA are often served by advanced practice nurses, due to the difficulty for such facilities to recruit physicians. In order to facilitate a full range of services for patients, some states permit advanced practice nurses to practice with full independence. However, many states limit their scopes of practice, resulting in the potential for limited healthcare access in underserved areas.

Examining variable nurse practitioner independence across jurisdictions: A case study of the United States.

Background: Nurse Practitioners have the potential to reduce primary care shortages for underserved populations. Yet, scopes of practice in some political jurisdictions (e.g.

Addressing Provider Shortages in Rural America: The Role of State Opt-Out Policy Adoptions in Promoting Hospital Anesthesia Provision.

Background: Shortages of anesthesia providers in rural areas have long resulted in access limitations in many US states. This situation prompted federal legislation designed to promote increased usage of certified registered nurse anesthetists (CRNAs) in hospitals. Starting in 2001, state governors were afforded the option to adopt "opt-out" provisions, giving facilities in their states flexibility in utilizing CRNAs; specifically, adopting the opt-out policy removes physician oversight requirements for Medicare billing purposes.

Telehealth Availability in US Hospitals in the Face of the COVID-19 Pandemic.

Background: Telehealth is likely to play a crucial role in treating COVID-19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals' readiness with respect to telehealth availability.

Understanding Professional Jurisdiction Changes in the Field of Anesthesiology.

We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy.