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Background: Reductions in primary care and specialist physicians follow rural hospital closures. As the supply of physicians declines, rural healthcare systems increasingly rely on nurse practitioners (NPs) and certified registered nurse anesthetists (CRNAs) to deliver care., Purpose: We sought to examine the extent to which rural hospital closures are associated with changes in the NP and CRNA workforce., Method: Using Area Health Resources Files (AHRF) data from 2010-2017, we used an event-study design to estimate the relationship between rural hospital closures and changes in the supply of NPs and CRNAs., Findings: Among 1,544 rural counties, we observed 151 hospital closures. After controlling for local market characteristics, we did not find a significant relationship between hospital closure and the supply of NPs and CRNAs., Discussion: We do not find evidence that NPs and CRNAs respond to rural hospital closures by leaving the healthcare market., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Primary care practices employing nurse practitioners (NPs) can play an important role in improving access to high quality health care services. However, most studies on the NP role in health care use administrative data, which have many limitations., Purpose: In this paper, we report the methods of the largest survey of primary care NPs to date., Methods: To overcome the limitations of administrative data, we fielded a cross-sectional, mixed-mode (mail/online) survey of primary care NPs in six states to collect data directly from NPs on their clinical roles and practice environments., Findings: While we were able to collect data from over 1,200 NPs, we encountered several challenges with our sampling frame, including provider turnover and challenges with identification of NP specialty., Discussion: In future surveys, researchers can employ strategies to avoid the issues we encountered with the sampling frame and enhance large scale survey data collection from NPs., (Copyright © 2021 Elsevier Inc. All rights reserved.)