A low-cost approach to national surveys of the nurse practitioner workforce in a resource-constrained environment

BACKGROUND: Health services researchers often rely on large surveys to report the quality and cost of nurse practitioner (NP)-delivered care. However, researchers face challenges obtaining sufficient response rates due to constrained federal research funding and difficulty reaching NPs at accurate addresses. NP health services researchers would benefit from feasible, lower cost approaches to conducting surveys. PURPOSE: This study reports the outcomes of a low-cost approach to national surveys of NPs. METHODOLOGY: This was a cross-sectional survey of primary care NPs serving older adults across 50 states and D.C. Names, addresses, and phone numbers were obtained for all 10,587 primary care NPs in Medical Marketing Service's NP File. Three recruitment letters were sent to the sampling frame via mail with a QR code and personal identifier. Response rates and costs were calculated to understand utility of the survey approach. RESULTS: The adjusted response rate was 6-15%, depending on assumptions. Survey administration costs totaled $24,775, excluding investigator salaries. CONCLUSIONS: This approach to a national NP survey yielded adjusted response rates comparable to federally funded surveys at a fraction of the cost. Savings stemmed from obtaining less expensive, unverified contact information, which included inaccurate addresses and created a need for stricter inclusion criteria screening. IMPLICATIONS: Researchers can save money and yield similar adjusted response rates as federally funded NP studies by administering surveys using letters with QR codes to an online survey and using unverified contact information, so long as inclusion screenings are strict and rigorous.