IDEAS home Printed from https://ideas.repec.org/p/fip/fedlwp/2005-071.html
   My bibliography  Save this paper

The practice boundaries of advanced practice nurses: an economic and legal analysis

Author

Listed:
  • Michael J. Dueker
  • Ada K. Jacox
  • David E. Kalist
  • Stephen J. Spurr

Abstract

The purpose of this study is to examine the causes and effects of State regulation that determines the extent of professional independence of advanced practice nurses (APNs). We analyze determinants of these regulations in panel data across States. We find that in States where APNs have acquired a substantial amount of professional independence, the earnings of APNs are substantially lower, and those of physicians' assistants are substantially higher, than in other States. These results are striking since physicians' assistants are in direct competition with APNs; the only real operational difference between these groups is that physicians' assistants are salaried employees who must work under the supervision of a physician. The implication is that physicians have responded to an increase in professional independence of APNs by hiring fewer APNs and more physicians' assistants.

Suggested Citation

  • Michael J. Dueker & Ada K. Jacox & David E. Kalist & Stephen J. Spurr, 2005. "The practice boundaries of advanced practice nurses: an economic and legal analysis," Working Papers 2005-071, Federal Reserve Bank of St. Louis.
    • Handle: RePEc:fip:fedlwp:2005-071
    as

    Download full text from publisher

    File URL: http://research.stlouisfed.org/wp/2005/2005-071.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. George J. Stigler, 1971. "The Theory of Economic Regulation," Bell Journal of Economics, The RAND Corporation, vol. 2(1), pages 3-21, Spring.
    2. Rosen, Sherwin, 1992. "The Market for Lawyers," Journal of Law and Economics, University of Chicago Press, vol. 35(2), pages 215-246, October.
    3. Stephen T. Mennemeyer & Gary Gaumer, 1983. "Nursing Wages and the Value of Educational Credentials," Journal of Human Resources, University of Wisconsin Press, vol. 18(1), pages 32-48.
    4. Edward J. Schumacher, "undated". "Relative Wages and the Returns to Education in the Labor Market for Registered Nurses," Working Papers 9720, East Carolina University, Department of Economics.
    5. Chang-Jin Kim & Charles R. Nelson, 1998. "Business Cycle Turning Points, A New Coincident Index, And Tests Of Duration Dependence Based On A Dynamic Factor Model With Regime Switching," The Review of Economics and Statistics, MIT Press, vol. 80(2), pages 188-201, May.
    6. LaVonne A. Booton & Julia I. Lane, 1985. "Hospital Market Structure and the Return to Nursing Education," Journal of Human Resources, University of Wisconsin Press, vol. 20(2), pages 184-196.
    7. A. Frank Adams III & Robert B. Ekelund Jr. & John D. Jackson, 2003. "Occupational Licensing of a Credence Good: The Regulation of Midwifery," Southern Economic Journal, John Wiley & Sons, vol. 69(3), pages 659-675, January.
    8. Breslaw, Jon A. & McIntosh, James, 1998. "Simulated latent variable estimation of models with ordered categorical data," Journal of Econometrics, Elsevier, vol. 87(1), pages 25-47, August.
    9. Edward J. Schumacher & Barry T. Hirsch, 1997. "Compensating Differentials and Unmeasured Ability in the Labor Market for Nurses: Why Do Hospitals Pay More?," ILR Review, Cornell University, ILR School, vol. 50(4), pages 557-579, July.
    10. Sass, Tim R & Nichols, Mark W, 1996. "Scope-of-Practice Regulation: Physician Control and the Wages of Non-Physician Health-Care Professionals," Journal of Regulatory Economics, Springer, vol. 9(1), pages 61-81, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Malakhov, Vladimir Sergeevich (Малахов, Владимир Сергеевич), 2016. "Evaluation of Risks, Threats and Challenges of Migration Policy in the Context of Long-Term Mass Presence on the Territory of Russian Refugees from Neighboring Countries [Оценка Рисков, Угроз И Зад," Working Papers 16610, Russian Presidential Academy of National Economy and Public Administration.
    2. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    3. John J. Perry, 2009. "The Rise And Impact Of Nurse Practitioners And Physician Assistants On Their Own And Cross‐Occupation Incomes," Contemporary Economic Policy, Western Economic Association International, vol. 27(4), pages 491-511, October.
    4. Patricia Pittman & Benjamin Williams, 2012. "Physician Wages in States with Expanded APRN Scope of Practice," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, February.
    5. Morris M. Kleiner & Allison Marier & Kyoung Won Park & Coady Wing, 2016. "Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service," Journal of Law and Economics, University of Chicago Press, vol. 59(2), pages 261-291.
    6. John J. Perry, 2012. "State-Granted Practice Authority: Do Nurse Practitioners Vote with Their Feet?," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, November.
    7. William H. Greene & David A. Hensher, 2008. "Modeling Ordered Choices: A Primer and Recent Developments," Working Papers 08-26, New York University, Leonard N. Stern School of Business, Department of Economics.
    8. McMichael, Benjamin, 2017. "Beyond Physicians: The Effect of Licensing and Liability Laws on the Supply of Nurse Practitioners and Physician Assistants," Working Papers 07538, George Mason University, Mercatus Center.
    9. 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.
    10. Park, Jee-Hyeong & Spurr, Stephen J. & Chang, Sheng-Kai, 2009. "A Model of Hierarchical Professionals: Cooperation and Conflict between Anesthesiologists and CRNAs," CEI Working Paper Series 2009-13, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    11. Alexander, Diane & Schnell, Molly, 2019. "Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health," Journal of Health Economics, Elsevier, vol. 66(C), pages 145-162.
    12. Benjamin J. McMichael, 2017. "The Demand for Healthcare Regulation: The Effect of Political Spending on Occupational Licensing Laws," Southern Economic Journal, John Wiley & Sons, vol. 84(1), pages 297-316, July.
    13. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Spetz, Joanne, 2002. "The value of education in a licensed profession: the choice of associate or baccalaureate degrees in nursing," Economics of Education Review, Elsevier, vol. 21(1), pages 73-85, February.
    2. Jones, Cheryl Bland & Gates, Michael, 2004. "Gender-based wage differentials in a predominantly female profession: observations from nursing," Economics of Education Review, Elsevier, vol. 23(6), pages 615-631, December.
    3. Edward J. Schumacher, 1999. ""The Earnings and Employment of Nurses in an Era of Cost Containment," Working Papers 9910, East Carolina University, Department of Economics.
    4. Sæther, Erik Magnus, 2009. "Compensating differentials for nurses," HERO Online Working Paper Series 2004:10, University of Oslo, Health Economics Research Programme.
    5. Botelho, Anabela & Bland Jones, Cheryl & Kiker, B. F., 1998. "Nursing wages and educational credentials: the role of work experience and selectivity bias," Economics of Education Review, Elsevier, vol. 17(3), pages 297-306, June.
    6. Till Bärnighausen & David Bloom, 2009. "Changing Research Perspectives on the Global Health Workforce," PGDA Working Papers 4609, Program on the Global Demography of Aging.
    7. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    8. Daniel J. Smith & Noah J. Trudeau, 2019. "The Undertaker’s Cut: Challenging the Rational Basis for Casket Licensure," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 34(Summer 20), pages 23-41.
    9. repec:ebl:ecbull:v:9:y:2008:i:23:p:1-14 is not listed on IDEAS
    10. Sæther, Erik Magnus, 2009. "Wage Policies for Health Personnel - Essays on the Wage Impact on Hours of Work and Practice Choice," HERO Online Working Paper Series 2005:1, University of Oslo, Health Economics Research Programme.
    11. Robert J. Thornton & Edward J. Timmons, 2013. "Licensing One of the World's Oldest Professions: Massage," Journal of Law and Economics, University of Chicago Press, vol. 56(2), pages 371-388.
    12. Edward J. Schumacher, "undated". "The Earnings and Employment of Nurses: Evidence from the 1990s," Working Papers 9803, East Carolina University, Department of Economics.
    13. Matthew Chesnes & Weijia (Daisy) Dai & Ginger Zhe Jin, 2014. "Banning Foreign Pharmacies from Sponsored Search: The Online Consumer Response," NBER Working Papers 20088, National Bureau of Economic Research, Inc.
    14. Persson, Torsten & Tabellini, Guido, 2002. "Political economics and public finance," Handbook of Public Economics, in: A. J. Auerbach & M. Feldstein (ed.), Handbook of Public Economics, edition 1, volume 3, chapter 24, pages 1549-1659, Elsevier.
    15. Carstensen, Kai & Heinrich, Markus & Reif, Magnus & Wolters, Maik H., 2020. "Predicting ordinary and severe recessions with a three-state Markov-switching dynamic factor model," International Journal of Forecasting, Elsevier, vol. 36(3), pages 829-850.
    16. Scott Gehlbach & Konstantin Sonin & Ekaterina Zhuravskaya, 2010. "Businessman Candidates," American Journal of Political Science, John Wiley & Sons, vol. 54(3), pages 718-736, July.
    17. Thomas Wyrick & Roger Arnold, 1989. "Earmarking as a deterrent to rent-seeking," Public Choice, Springer, vol. 60(3), pages 283-291, March.
    18. Pavel Ciaian & Ján Pokrivčák & Dušan Drabik, 2008. "Prečo sú niektoré sektory v tranzitívnych ekonomikách menej reformované ako ostatné? prípad výskumu a vzdelávania v oblasti ekonómie [Why some sectors of transition economies are less reformed than," Politická ekonomie, Prague University of Economics and Business, vol. 2008(6), pages 819-836.
    19. Kris James Mitchener & Matthew Jaremski, 2014. "The Evolution of Bank Supervision: Evidence from U.S. States," NBER Working Papers 20603, National Bureau of Economic Research, Inc.
    20. Masciandaro, D. & Nieto, M. & Prast, H.M., 2007. "Financial Governance of Banking Supervision," Other publications TiSEM 65d7ff26-dca3-4da3-86ff-6, Tilburg University, School of Economics and Management.
    21. J. Mark Ramseyer & Eric Rasmusen, 2013. "Lowering the Bar to Raise the Bar: Licensing Difficulty and Attorney Quality in Japan," Working Papers 2013-12, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:fip:fedlwp:2005-071. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Anna Oates (email available below). General contact details of provider: https://edirc.repec.org/data/frbslus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.