Wk4/dis/reply/AR

Hamric et al., (2019) said it best when they stated, "Focusing on the outcomes of APRN care is an essential component in demonstrating the impact of the role as well as contributions to quality and safe patient care," (p. 606). Not only does advance practice nursing (APN) demonstrate a reduction in errors because of the efficient and effective time spent with patients and misuse or overuse of services, but also cost-effectiveness for both the facility and the patients.

One study done discusses in further detail the importance of reducing or eliminating the scope of practice restrictions for nurse practitioners. Chattopadhyay and Zangaro (2019) begin by noting that nurse practitioners (NPs) are able to provide direct patient care in a variety of settings and have provided care to over 1.06 billions patients per year (p. 273). This is important to note as the scope of practice, education, and credentialing that nurse practitioners allow access to be improved, which, in turn, will improve quality of care and patient outcomes. The study moves on to discuss, "NPs are certified to provide care to specific populations (e.g. adults, geriatrics, pediatrics, family care, women's health, psychiatry. . . ) and provide most of the same services as physicians" (Chattopadhyay & Zangaro, 2019, p. 273). Keeping this in mind, one can determine the cost effectiveness of utilizing a nurse practitioner over a physician and, thus, determine that lessening restrictions on the scope of practice can create a reduction in cost. The study begins by discussing via literature review findings from various studies that were performed to determine cost effectiveness. The study then considers what they term "cost avoidance" and cite "wage gap [(significant difference in salaries of physicians compared to nurse practitioners)]", "differences in Medicare reimbursement", and "labor market competition for efficiency [(resulting in reduction in cost of primary care services)]" (Chattopadhyay & Zangaro, 2019, p. 275). These are all factors that are important to note and measured within the design of the study. First of all, the data that was gathered for this study came from Area Health Resources Files (AHRF), which is data that is available to the public from various sources (such as the Centers for Medicare and Medicaid Services). This includes information on Medicare costs, population in regards to the providers available and the public population including information on socioeconomics and demographics; and this information is used to compare costs with summary statistics of inpatient services, outpatient services and visits, and emergency department visits (Chattopadhyay & Zangaro, 2019, p. 276). Due to the fact that nurse practitioners are capable of providing the same services as physicians after the appropriate education, credentialing, and licensing, the study found that millions to billions of dollars can be saved annually by eliminating the scope of practice restrictions for nurse practitioners and, thus, allowing for cost effectiveness. For example, results demonstrated that if restrictions were lifted in 29 states, there would be a savings of $44.5 billion (Chattopadhyay & Zangaro, 2019, p. 279). Again, this reverts back to savings due to a reduction in cost due to salary, Medicare reimbursement, and the actual cost of services. This cost effectiveness is critical to patient outcomes as this increases access, improves care provided to the patients when they seek services, and can ultimately reduce errors because of the time spent with patients.