Establishing the relationship between nurse practitioner integration and reductions in health disparities

Background: Nurse practitioners are widely recognized for their holistic, patient-centered approach, which addresses the needs of patients, their families, and the communities they serve. Nurse practitioner care is noted internationally for reducing health disparities by improving care access and quality for underserved populations. However, there is limited empirical evidence on how well nurse practitioners are integrated into care models, which impacts the nurse practitioner workforce’s ability to reduce health disparities. This study aimed to explore how the extent of the integration of nurse practitioners within care models influences health disparities. Methods: This was part of a larger Delphi study guided by the Nurse Practitioner Integration Model. Open-ended surveys were sent to scholars and practice experts with experience in nurse practitioner integration. Data were collected from 29 participants. Inductive content analysis and member checking ensured the rigor and credibility of the results. Results: Two core themes emerged: First, poor integration and limited role autonomy in the collaborating organization restrict nurse practitioner capacity to promote equity and decrease disparities, largely due to organizational policies that fail to prioritize nurse practitioner integration. Second, the distinct nurse practitioner approach is an untapped opportunity to increase equity and reduce disparities in low-integration settings, whereby well-integrated nurse practitioners could significantly impact outcomes in underserved populations. Conclusions: Effective nurse practitioner integration is crucial for advancing the United Nations Sustainable Development Goals, which emphasize improving health and wellbeing for all through diminished disparities. Policies and investment should prioritize full integration of nurse practitioners into care teams and organizations, maximizing their holistic, patient-centered approach to care and leveraging their unique contributions to expand access and promote health equity for underserved populations.