The Advanced Practice Nurse will play a crucial role in advancement of the healthcare system in the United States. There are several factors affecting today’s healthcare system which will influenced the future development of the Advanced Practice Nurse (APN) role. Some of the major factors include the evolving federal and states laws, rapidly growing and aging population, increasing rates of chronic diseases in children and adults, and the cost of healthcare. These challenges require increase need for well trained healthcare professionals (OJN). The Patient Protection and Affordable Care Act (ACA) that was singed into law March 23, 2010 had the greatest impact in healthcare reform in the United States since the creation of Medicare and Medicaid in 1965. This legislation established emphasis on preventive services with focus on primary care, funds for community health initiatives, and improve quality of care. It also afforded health insurance to millions of Americans who are currently uninsured (OJN).
The influx of new patients will stress an already strained healthcare system. According to the American Academy of Family physicians, by 2020, the United States will need 40 percent more primary care providers . One way to meet the increasing shortage of primary care provider is to enhance and expedite the growth of Advanced Practice Registered Nurse. A government accounting office noted that Nurse Practitioner are the fastest growing group of primary care providers . (p-241-242). Nurse practitioners could fill the growing shortage of primary care more quickly than physicians. It only takes nurses 6 years of education and training while physicians may require 11-12 years.(health policy) The Advanced Practice Nurse role is also defined by the individual state’s Rules, regulations and statutes.
Advanced Practice Registered Nurse practitioners in most states are still fighting their state laws which prevents them from independently practicing without a collaborative agreement with a physician. Currently only 19 states and the District of Columbia allow nurse practitioners to practice independently of a physician. (KHN) The American Nurses Association conducted a review of 19 studies in May 2010, which confirmed that care delivered by a nurse equivalent is equivalent to care provided by a physician.. In addition, the study showed that NP’s consistenly provided more patient care, follow-up, and Consultation time, b(OOO) Another factor that has impact on the future role of Advanced Practice Nurse is the increase healthcare needs of the aging population and chronic Diseases of children and adults. (Impact). More complex healthcare needs increases The cost of healthcare. The cost of U.S. healthcare is $7,538 per capita spending.
This is nearly double than any other organization. (OJN) Nurse practitioner Providing care in primary care is less costly than a physician since since they tend to offer fewer to tests and expensive diagnostic procedure. According to the federal Health Resources and Services Administration, or HRSA, at least 55 million Americans live in areas with an inadequate supply of primary care doctors. Massachusetts has the most primary care doctors per capita; Mississippi has the fewest. The nation would need more than 15,000 additional providers to meet the target ratio of one primary care practitioner for every 3,500 residents, according to HRSA, a gap that cannot be filled with physicians. The Association of American Medical Colleges predicts a worsening shortage ahead. In the next 10 years, as one-third of all doctors retire, there will be 90,000 fewer doctors than needed to serve the nation’s aging population.
Half of the shortage will be in primary care. Nationwide, 117,000 physicians practiced family medicine in 2012, according to the Kaiser Family Foundation; 134,000 nurse practitioners practiced primary care, according to the American Association of Nurse Practitioners. Last year, only 1,916 U.S. medical school graduates, or about 12 percent of the total, went into primary care residency programs, according to the nonprofit research group National Resident Matching Program. Nursing school graduates who went into primary care totaled 11,764 in 2012, about 84 percent of all NP graduates. But will relaxing state NP licensing laws improve patient access to care? A study reported this month in the journal Health Affairs says yes. The authors found that between 1998 and 2010, as more states relaxed licensing laws, the number of patients receiving care from NPs increased by a factor of 15.
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