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Nurse practitioner scope of practice and patient harm: Evidence from medical malpractice payouts and adverse action reports

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  • Sara Markowitz
  • Andrew J. D. Smith

Abstract

Many states have recently changed their scope of practice laws and granted full practice authority to nurse practitioners, allowing them to practice without oversight from physicians. Physician groups have argued against this change, citing patient safety concerns. In this paper, we use a ratio‐in‐ratio approach to evaluate whether the transition to full practice authority results in harm to patients as proxied by malpractice payouts and adverse action reports against nurse practitioners. We find no evidence of such harm, and instead find that physicians may benefit from the law change in terms of reduced paid malpractice cases against them.

Suggested Citation

  • Sara Markowitz & Andrew J. D. Smith, 2024. "Nurse practitioner scope of practice and patient harm: Evidence from medical malpractice payouts and adverse action reports," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 43(2), pages 420-445, March.
  • Handle: RePEc:wly:jpamgt:v:43:y:2024:i:2:p:420-445
    DOI: 10.1002/pam.22507
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    References listed on IDEAS

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    1. Bernard S. Black & Amy R. Wagner & Zenon Zabinski, 2017. "The Association between Patient Safety Indicators and Medical Malpractice Risk: Evidence from Florida and Texas," American Journal of Health Economics, University of Chicago Press, vol. 3(2), pages 109-139, Spring.
    2. 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.
    3. Sara Markowitz & E. Kathleen Adams, 2022. "The Effects of State Scope of Practice Laws on the Labor Supply of Advanced Practice Registered Nurses," American Journal of Health Economics, University of Chicago Press, vol. 8(1), pages 65-98.
    4. 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.
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    7. Benjamin Ho & Elaine Liu, 2011. "Does sorry work? The impact of apology laws on medical malpractice," Journal of Risk and Uncertainty, Springer, vol. 43(2), pages 141-167, October.
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    9. Baker, Andrew C. & Larcker, David F. & Wang, Charles C.Y., 2022. "How much should we trust staggered difference-in-differences estimates?," Journal of Financial Economics, Elsevier, vol. 144(2), pages 370-395.
    10. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    11. Bernard S. Black & Amy R. Wagner & Zenon Zabinski, 2017. "The Association between Patient Safety Indicators and Medical Malpractice Risk: Evidence from Florida and Texas," American Journal of Health Economics, MIT Press, vol. 3(2), pages 109-139, Spring.
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