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September 6, 2026Geriatric NursingOpen Access

Comparative analysis of older adult outcomes in states with and without nurse practitioner full practice authority states: a national secondary data analysis

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Authors

JFJoyce J. FitzpatrickUniversity of AkronAPAlicia PlemmonsWest Virginia UniversityEDEvelyn DuffyCase Western Reserve University

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Implication

Retrospective policy analysis demonstrates improved functional status and appropriate emergency care in older adults, suggesting nurse practitioner autonomy enhances geriatric healthcare delivery.

Key Points

  • To evaluate the impact of state-level nurse practitioner full practice authority on healthcare access, daily functional status, medication patterns, and cancer detection among adults aged 65–84 years.
  • Analyzed restricted Medical Expenditure Panel Survey (MEPS) data from 2010 to 2019 for older adults aged 65–84 years.
  • Employed a difference-in-differences design comparing states adopting full practice authority against non-adopting states during the observation window.
  • Estimated adjusted incidence rate ratios and regression coefficients controlling for rurality and county–state level clustering.
  • Implementation of full practice authority was associated with fewer diagnostic emergency department visits and a greater proportion of true emergency-related visits.
  • Older adults in full practice authority states demonstrated significantly better functional status in instrumental activities of daily living, with the largest improvements in rural areas.
  • Adoption of full practice authority corresponded to modest increases in the detection of several cancer types, while findings on medication use patterns remained mixed.

Cite This Study

Fitzpatrick et al. (2026) studied this question.

synapsesocial.com/papers/6a9d1e6328139818eab211fehttps://doi.org/10.1016/j.gerinurse.2026.104343
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  1. 1Nurse Practitioner–Physician Comanagement of Patients in Primary Care2018 · 19 citations