Rural Patients’ Perceptions and Opinions of Scope of Practice

Introduction.Primary care shortages pose a challenge to healthcare access in rural communities.In April 2022, Kansas granted "full practice authority," permitting advanced practice registered nurses (APRNs) to manage treatments and prescribe medication without supervision or collaboration with a physician.This study investigated patients' perceptions and opinions surrounding scope of practice and healthcare accessibility. Methods. Researchers conducted a cross-sectional survey of rural patients seen in participating clinics in the Summer Training Option in Rural Medicine (STORM) program in Kansas betweenJune and July 2023.Chi-square tests of independence were employed to test differences between age groups, education level, and years rural.Results.Respondents (n = 272) reported feeling familiar with scope of practice and understanding differences in training, licensure, or oversight, but often answered "I am not sure" when asked about provider-specific practice settings and oversight.Many respondents (42.0%) felt neutral towards preferring a physician PCP, but statistically significant reductions in neutrality were associated with increased age (x² = 16.04,p = 0.003).Education level was less influential than other demographics in provider preference.Most (54.6%) rural patients felt independent practice by APRNs would lead to improved access to care, though many (59.2%) reported not knowing about the new law. Conclusions.Results of this study imply that rural patients have mixed understanding of their healthcare provider's legal scope of practice and how to apply their understanding in utilization of services.Additional studies examining patients' values, health outcomes, and access increases would provide more information about influences in preference and improving rural healthcare delivery.