← ireadpaper · 顶刊中的公共政策研究

执业范围限制对医疗服务可及性的影响

The impact of scope-of-practice restrictions on access to medical care
Journal of Health Economics · 2024 · Guo, Jiapei、Kilby, Angela E.、Marks, Mindy S.

中文摘要

我们研究了在高度监管且重要的政策情境——阿片类药物使用障碍的药物辅助治疗供给——中执业范围法的影响。我们考察了由州和联邦层面政策变化所生成的两个自然实验,这些政策变化赋予执业护士更多的执业自主权。两个实验均表明,处方权的放宽带来了医疗服务可及性的大幅改善。进一步地,我们使用丰富的地址层面数据来回答关键政策问题。扩大执业护士的处方权缩小了医疗服务可及性的城乡差距。此外,自主权的扩大还增加了由医生提供的医疗服务可及性,这源于不同服务提供者之间的互补性。

Abstract

We study the impact of scope-of-practice laws in a highly regulated and important policy setting, the provision of medication-assisted treatment for opioid use disorder. We consider two natural experiments generated by policy changes at the state and federal level that allow nurse practitioners more practice autonomy. Both experiments show that liberalizations of prescribing authority lead to large improvements in access to care. Further, we use rich address-level data to answer key policy questions. Expanding nurse practitioner prescribing authority reduces urban–rural disparities in health care access. Additionally, expanded autonomy increases access to care provided by physicians, driven by complementarities between providers.
在 ireadpaper 查看全部 →