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

Adding a PA to a rural Community ICU

Authors

  • Donald Fung, MD north bay regional health center
  • Joseph Caswell, Ph.D. Health Sciences North Research Institute; Northeast Cancer Centre
  • Tanya James North Bay Regional Health Center
  • Gavan Harmen, MD North Bay Regional Health Center
  • Kerry Reed, MD Northern Ontario School of Medicine, Department of Family Practice
  • Michael Conlon, Ph.D Epidemiology, Outcomes & Evaluation Research Health Sciences, North Research Institute
  • Venessa Charette North Bay Regional Health Center

Keywords:

PAs or physician assistants, Canada, ontario, community care hospital, intensive care units

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.       

 

Author Biographies

Donald Fung, MD, north bay regional health center

Anesthesiologist, Chief of Staff, Executive VP Medical Affairs

North Bay Regional Health Center

50 College Drive, North Bay Ontario P1A 5A4

Joseph Caswell, Ph.D., Health Sciences North Research Institute; Northeast Cancer Centre

Lead Analyst, Head of Research and Analysis; ICES North; Epidemiology, Outcomes & Evaluation Research

Health Sciences North Research Institute; Northeast Cancer Centre

Tanya James, North Bay Regional Health Center

CHIM; North Bay Regional Health Center

50 College Drive, North Bay Ontario, P1A 5A4

Gavan Harmen, MD, North Bay Regional Health Center

Department of Internal Medicine (Nephrology); North Bay Regional Health Center

50 College Drive; North Bay Ontario P1A 5A4

 

Kerry Reed, MD, Northern Ontario School of Medicine, Department of Family Practice

Assistant Professor, Northern Ontario School of Medicine; Department of Family Practice

North Bay Regional Health Center

50 College Drive, North Bay Ontario, P1A 5A4

Michael Conlon, Ph.D, Epidemiology, Outcomes & Evaluation Research Health Sciences, North Research Institute

Director, Epidemiology, Outcomes & Evaluation Research

Health Sciences North Research Institute

c/o HSNRI, 41 Ramsey Lake Road, Sudbury, ON, P3E 5J1

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Published

2021-01-25

How to Cite

Fung, MD MSc. FRCPC, D., Caswell, Ph.D., J., James, T., Harman, MD, MSc, FRCPC , G. ., Reed, MD PhD CCFP, K. ., Conlon, Ph.D, M., & Charette, V. (2021). The impact of adding a physician assistant to a rural community hospital intensive care unit: Adding a PA to a rural Community ICU. The Journal of Canada’s Physician Assistants, 2(6), p1–11. Retrieved from https://ojs.lib.umanitoba.ca/index.php/jcpa/article/view/873

Issue

Section

Original Research