Health outcomes and provider choice under full practice authority for certified nurse-midwives.
J Health Econ
; 92: 102817, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-37778146
ABSTRACT
Full practice authority grants non-physician providers the ability to manage patient care without physician oversight or direct collaboration. In this study, we consider whether full practice authority for certified nurse-midwives (CNMs/CMs) leads to changes in health outcomes or CNM/CM use. Using U.S. birth certificate and death certificate records over 2008-2019, we show that CNM/CM full practice authority led to little change in obstetric outcomes, maternal mortality, or neonatal mortality. Instead, full practice authority increases (reported) CNM/CM-attended deliveries by one percentage point while decreasing (reported) physician-attended births. We then explore the mechanisms behind the increase in CNM/CM-attended deliveries, demonstrating that the rise in CNM/CM-attended deliveries represents higher use of existing CNM/CMs and is not fully explainable by improved reporting of CNM/CM deliveries or changes in CNM/CM labor supply.
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Base de dados:
MEDLINE
Assunto principal:
Tocologia
/
Enfermeiros Obstétricos
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article