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供给侧卫生政策:执业范围法律对死亡率的影响

Supply-side health policy: The impact of scope-of-practice laws on mortality
Journal of Public Economics · 2023 · Benjamin J. McMichael

中文摘要

更多使用执业护士(NP)和医师助理/医师协理(PA)提供医疗服务,是扩大医疗服务可及性的一项重要供给侧政策选择。然而,限制性的执业范围法律制约了其提供医疗服务的能力。本文考察放宽这些执业范围法律对医疗可避免死亡的影响,此类死亡对医疗服务可及性较为敏感。通过分析美国2005年至2019年的死亡数据,我发现,放宽执业护士的执业范围法律使每10万人中的医疗可避免死亡人数减少12人,放宽医师助理/医师协理的执业范围法律则使该死亡人数每10万人减少10人,且农村地区的降幅更大。

Abstract

The increased use of nurse practitioners (NPs) and physician assistants/associates (PAs) to provide healthcare represents an important supply-side policy option to expand access to care. However, restrictive scope-of-practice laws limit their ability to deliver care. I examine the effect of relaxing these scope-of-practice laws on healthcare amenable deaths, which are sensitive to access to care. Analyzing deaths in the United States between 2005 and 2019, I find that relaxing NP scope-of-practice laws reduces healthcare amenable deaths by 12 per 100,000 individuals and that relaxing PA scope-of-practice laws reduces these deaths by 10 per 100,000, with larger reductions in rural areas.
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