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Improving health care efficiency through the integration of a physician assistant into an infectious diseases consult service at a large urban community hospital.

Decloe M, McCready J, Downey J, Powis J - Can J Infect Dis Med Microbiol (2015 May-Jun)

Bottom Line: Mortality did not significantly change after PA introduction in either cases or controls.PAs can improve health efficiencies in the Canadian health care setting, leading to reduction in LOS.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Physician Assistant Education Program, McMaster University, Hamilton, Ontario;

ABSTRACT

Background: Physician assistants (PAs) have recently been introduced into the Canadian health care system in some provinces; however, there are little data demonstrating their impact.

Methods: A retrospective case-control study was conducted between January 2010 and December 2013. Length of stay (LOS) and mortality were examined in the infectious diseases consult service (IDCS) compared with hospital-wide controls. The two-year period before the introduction of the PA to the IDCS of a large urban community hospital in Canada (2010 to 2011) was compared with the two-year period following the introduction of the PA (2012 to 2013).

Results: Following the introduction of a PA to the IDCS, there was a decrease in time to consultation from 21.4 h to 14.3 h (P<0.0001). LOS was significantly decreased among IDCS patients by 3.6 days more than that seen in matched hospital-wide controls (P=0.0001). Mortality did not significantly change after PA introduction in either cases or controls.

Discussion/conclusion: PAs can improve health efficiencies in the Canadian health care setting, leading to reduction in LOS.

No MeSH data available.


Related in: MedlinePlus

Violin plot illustrating the distribution of length of stay (LOS) in the infectious diseases consult service cohort (cases and the hospital-wide cohort [controls]) pre and post introduction of the infectious diseases physician assistant. The average LOS in each group is illustrated with the bold black line. The differential change in LOS in the cases and the controls is statistically significant (P<0.0001)
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f1-idmm-26-130: Violin plot illustrating the distribution of length of stay (LOS) in the infectious diseases consult service cohort (cases and the hospital-wide cohort [controls]) pre and post introduction of the infectious diseases physician assistant. The average LOS in each group is illustrated with the bold black line. The differential change in LOS in the cases and the controls is statistically significant (P<0.0001)

Mentions: Among patients seen by the IDCS, there was 21.0% reduction in LOS, with the average LOS decreasing from 20.5 days to 16.2 days following the introduction of the PA. In the hospital-wide matched cohort, there was a 10.6% reduction in LOS, with the average LOS decreasing from 6.8 days to 6.1 days from the pre- to postintervention period. There is a statistically significant decrease in the differential change of LOS among patients seen by the IDCS compared with the hospital-wide matches of 3.6 days (95% CI 1.8 to 5.5 days; P=0.0001) (Figure 1).


Improving health care efficiency through the integration of a physician assistant into an infectious diseases consult service at a large urban community hospital.

Decloe M, McCready J, Downey J, Powis J - Can J Infect Dis Med Microbiol (2015 May-Jun)

Violin plot illustrating the distribution of length of stay (LOS) in the infectious diseases consult service cohort (cases and the hospital-wide cohort [controls]) pre and post introduction of the infectious diseases physician assistant. The average LOS in each group is illustrated with the bold black line. The differential change in LOS in the cases and the controls is statistically significant (P<0.0001)
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507837&req=5

f1-idmm-26-130: Violin plot illustrating the distribution of length of stay (LOS) in the infectious diseases consult service cohort (cases and the hospital-wide cohort [controls]) pre and post introduction of the infectious diseases physician assistant. The average LOS in each group is illustrated with the bold black line. The differential change in LOS in the cases and the controls is statistically significant (P<0.0001)
Mentions: Among patients seen by the IDCS, there was 21.0% reduction in LOS, with the average LOS decreasing from 20.5 days to 16.2 days following the introduction of the PA. In the hospital-wide matched cohort, there was a 10.6% reduction in LOS, with the average LOS decreasing from 6.8 days to 6.1 days from the pre- to postintervention period. There is a statistically significant decrease in the differential change of LOS among patients seen by the IDCS compared with the hospital-wide matches of 3.6 days (95% CI 1.8 to 5.5 days; P=0.0001) (Figure 1).

Bottom Line: Mortality did not significantly change after PA introduction in either cases or controls.PAs can improve health efficiencies in the Canadian health care setting, leading to reduction in LOS.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Physician Assistant Education Program, McMaster University, Hamilton, Ontario;

ABSTRACT

Background: Physician assistants (PAs) have recently been introduced into the Canadian health care system in some provinces; however, there are little data demonstrating their impact.

Methods: A retrospective case-control study was conducted between January 2010 and December 2013. Length of stay (LOS) and mortality were examined in the infectious diseases consult service (IDCS) compared with hospital-wide controls. The two-year period before the introduction of the PA to the IDCS of a large urban community hospital in Canada (2010 to 2011) was compared with the two-year period following the introduction of the PA (2012 to 2013).

Results: Following the introduction of a PA to the IDCS, there was a decrease in time to consultation from 21.4 h to 14.3 h (P<0.0001). LOS was significantly decreased among IDCS patients by 3.6 days more than that seen in matched hospital-wide controls (P=0.0001). Mortality did not significantly change after PA introduction in either cases or controls.

Discussion/conclusion: PAs can improve health efficiencies in the Canadian health care setting, leading to reduction in LOS.

No MeSH data available.


Related in: MedlinePlus