First Advisor

Gilbert, Marcia


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

80 pages


Abstract Background: Research findings continue to demonstrate populations who lack healthcare insurance have limited or restricted access to primary healthcare. Lack of health insurance has been shown to be the most significant contributing factor to poor quality of care for some of the core measures captured by the Agency for Healthcare Research and Quality. Health insurance coverage is highly correlated with an individual's ability to gain access to health care, from doctor visits to filling prescriptions. Purpose: The purpose of the this Capstone Project was to analyze the potential impact of independent Nurse Practitioner models of care on accessibility and cost-effectiveness in the delivery of primary health care for underserved populations, specifically those lacking health care insurance. Methods: Data findings were accomplished with the completion of an instrument survey tool. The population sample size for the study was N=24 based on statistical application of power analysis. The data was analyzed and presented using descriptive statistical measurement. Findings: The process outcome measurement related to access found that 79% of the participants had same day appointments, 5% were scheduled for the next day, and 16% waited two days to be seen. Demographic findings showed 70% of the participants had healthcare insurance, while 30% did not. The outcome measurement addressing healthcare decision making gave unexpected findings in that 100% of the participants answered that they could afford the cost of today's visit. Conclusions: These findings support the Capstone Project study premise that independent NP models of care create cost-effective healthcare for underserved populations, specifically those without healthcare insurance. The study unexpectedly found independent NP models of care also create cost-effective healthcare for populations having healthcare insurance. The study premise addressing improved access to care could not be fully explored due to lack of benchmarking or comparison against other models of healthcare. Further study is needed to evaluate the impact of independent NP models of care for all consumers of primary healthcare.

Date of Award

Spring 2012

Location (Creation)

Denver, Colorado

Rights Statement

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