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Just What the Nurse Practitioner Ordered: Independent Prescriptive Authority and Population Mental Health

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  • Diane Alexander
  • Molly Schnell

Abstract

We examine whether relaxing occupational licensing to allow nurse practitioners (NPs)?registered nurses with advanced degrees?to prescribe medication without physician oversight is associated with improved population mental health. Exploiting time-series variation in independent prescriptive authority for NPs from 1990?2014, we find that broadening prescriptive authority is associated with improvements in self-reported mental health and decreases in mental-health-related mortality, including suicides. These improvements are concentrated in areas underserved by psychiatrists and among populations traditionally underserved by mental health providers. Our results demonstrate that extending prescriptive authority to NPs can help mitigate physician shortages and extend care to disadvantaged populations.

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  • Diane Alexander & Molly Schnell, 2016. "Just What the Nurse Practitioner Ordered: Independent Prescriptive Authority and Population Mental Health," Working Paper Series WP-2017-8, Federal Reserve Bank of Chicago.
    • Handle: RePEc:fip:fedhwp:wp-2017-08
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    Cited by:

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    2. Petri Bockerman & Mika Haapanen & Christopher Jepsen, 2021. "Dark Passage: Mental Health Consequences of Parental Death," Working Papers 202107, Geary Institute, University College Dublin.
    3. Laura Barrie Smith, 2022. "The effect of nurse practitioner scope of practice laws on primary care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 21-41, January.
    4. Jie Chen & Chad D. Meyerhoefer & Edward J. Timmons, 2024. "The effects of dental hygienist autonomy on dental care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1726-1747, August.
    5. Anca M. Grecu & Lee C. Spector, 2019. "Nurse practitioner's independent prescriptive authority and opioids abuse," Health Economics, John Wiley & Sons, Ltd., vol. 28(10), pages 1220-1225, October.
    6. Chen, Alice J. & Munnich, Elizabeth L. & Parente, Stephen T. & Richards, Michael R., 2023. "Provider turf wars and Medicare payment rules," Journal of Public Economics, Elsevier, vol. 218(C).
    7. Guo, Jiapei & Kilby, Angela E. & Marks, Mindy S., 2024. "The impact of scope-of-practice restrictions on access to medical care," Journal of Health Economics, Elsevier, vol. 94(C).
    8. Hoehn-Velasco, Lauren & Jolles, Diana R. & Plemmons, Alicia & Silverio-Murillo, Adan, 2023. "Health outcomes and provider choice under full practice authority for certified nurse-midwives," Journal of Health Economics, Elsevier, vol. 92(C).
    9. RoyChoudhury, Agnitra & Petrova, Kameliia, 2023. "Impact of New York state nurse practitioners modernization act on quality of care," Economics Letters, Elsevier, vol. 230(C).
    10. Tianyuan Luo & Cesar L. Escalante & Carmina E. Taylor, 2021. "Labor market outcomes of granting full professional independence to nurse practitioners," Journal of Regulatory Economics, Springer, vol. 60(1), pages 22-54, August.

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    More about this item

    Keywords

    C-sections; Disability insurance; Medically underserved areas; Mental health; Nurse practitioner; Population;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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