The impact of adding a physician assistant to a rural community hospital intensive care unit
Adding a PA to a rural Community ICU
Keywords:PAs or physician assistants, Canada, ontario, community care hospital, intensive care units
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.
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Copyright (c) 2020 Donald Fung, MD MSc. FRCPC, Joseph Caswell, Ph.D., Tanya James, Gavan Harman, MD, MSc, FRCPC , Kerry Reed, MD PhD CCFP, Michael Conlon, Ph.D
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