Do advanced practice nurses and physician assistants benefit small rural hospitals?

Advanced practice nurses and physician assistants have offered small, rural hospitals an alternative to scarce primary care physicians for 30 years. T his paper uses survey data from 285 small rural hospitals and case studies of 36 of these hospitals and case studies of 36 of these hospitals to answe r questions about the extent to which advanced practice nurses and physicia n assistants provide primary care in small, rural hospitals, the benefits t hat might bring to the hospitals as well as the reactions of the public. Th e study used survey data collected as part of an evaluation of 285 hospital s, which received a Rural Health Care Transition grant from the Health Care Financing Administration in 1993 and 1994. Most of the hospitals used the practitioners; 70 percent used nurse practitioners; 30 percent used physici an assistants; and 20 percent used both. There were some negative reactions to the use of the practitioners, but, overall, there was acceptance and be nefits to the hospitals in the form of reduced recruitment costs, increased revenues and increased service offerings. These practitioners are benefici al to rural hospitals, and mechanisms to encourage their acceptance should be developed and implemented.