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

DOI:

https://doi.org/10.5203/jcanpa.v2i6.873

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

    1

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Published

2021-01-25

Issue

Section

Original Research

How to Cite

The impact of adding a physician assistant to a rural community hospital intensive care unit: Adding a PA to a rural Community ICU. (2021). The Journal of Canada’s Physician Assistants, 2(6), p1-11. https://doi.org/10.5203/jcanpa.v2i6.873

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