The impact of adding a physician assistant to a rural community hospital intensive care unit

Adding a PA to a rural Community ICU

Abstract

Physician Assistants (PAs) are being used to enhance service delivery in a variety of practice settings. This study investigated the impact of adding a physician assistant to an internist team covering a rural community hospital Intensive Care Unit (ICU) in North East Ontario.  Retrospective chart reviews and CIHI data extraction was done on a cohort of ICU patients prior to the hiring of a PA (no PA) and compared to a cohort of ICU patients who had received care from a PA during their ICU stay. Inverse probability of treatment propensity scores were applied to match a no PA cohort (n=136) to a PA cohort (n=132).  Cohorts were matched to gender, age, comorbidity, and diagnostic groups.  The use of a PA was associated with a trend towards lower mortality (42% vs 27%, p<0.07) and no difference in readmission rates or resource intensity.  Post PA patients had greater lengths of CCU and hospital stay (19 hrs, p<0.002; 2 days, p<0.002) and more complete admission notes (p<0.003).  Adding a PA was associated with greater CCU and hospital length of stay, more complete admission notes and a trend towards improved mortality.