Physician associates and GPs in primary care: a comparison
<p><strong>Background:</strong> Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.</p> <p><strong>Aim:</strong> This study aimed...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2015
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| _version_ | 1811140260112891904 |
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| author | Drennan, VM Halter, M Joly, L Gage, H Grant, RL Gabe, J Brearley, S Carneiro, W de Lusignan, S |
| author_facet | Drennan, VM Halter, M Joly, L Gage, H Grant, RL Gabe, J Brearley, S Carneiro, W de Lusignan, S |
| author_sort | Drennan, VM |
| collection | OXFORD |
| description | <p><strong>Background:</strong> Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.</p>
<p><strong>Aim:</strong> This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs.</p>
<p><strong>Design and setting:</strong> An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England.</p>
<p><strong>Method:</strong> PA consultations were compared with those of GPs. Primary outcome was re-consultation within 14 days for the same or linked problem. Secondary outcomes were processes of care.</p>
<p><strong>Results:</strong> There were no significant differences in the rates of re-consultation (rate ratio 1.24, 95% confidence interval [CI] = 0.86 to 1.79, <em>P</em> = 0.25). There were no differences in rates of diagnostic tests ordered (1.08, 95% CI = 0.89 to 1.30, <em>P</em> = 0.44), referrals (0.95, 95% CI = 0.63 to 1.43, <em>P</em> = 0.80), prescriptions issued (1.16, 95% CI = 0.87 to 1.53, <em>P</em> = 0.31), or patient satisfaction (1.00, 95% CI = 0.42 to 2.36, <em>P</em> = 0.99). Records of initial consultations of 79.2% (<em>n</em> = 145) of PAs and 48.3% (<em>n</em> = 99) of GPs were judged appropriate by independent GPs (<em>P</em><0.001). The adjusted average PA consultation was 5.8 minutes longer than the GP consultation (95% CI = 2.46 to 7.1; <em>P</em><0.001); cost per consultation was GBP £6.22, (US$ 10.15) lower (95% CI = −7.61 to −2.46, <em>P</em><0.001).</p>
<p><strong>Conclusion:</strong> The processes and outcomes of PA and GP consultations for same-day appointment patients are similar at a lower consultation cost. PAs offer a potentially acceptable and efficient addition to the general practice workforce.</p> |
| first_indexed | 2024-09-25T04:19:09Z |
| format | Journal article |
| id | oxford-uuid:95b2473a-5b95-4f69-b1a7-2880310ec523 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:19:09Z |
| publishDate | 2015 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:95b2473a-5b95-4f69-b1a7-2880310ec5232024-07-24T14:32:16ZPhysician associates and GPs in primary care: a comparisonJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:95b2473a-5b95-4f69-b1a7-2880310ec523EnglishSymplectic ElementsRoyal College of General Practitioners2015Drennan, VMHalter, MJoly, LGage, HGrant, RLGabe, JBrearley, SCarneiro, Wde Lusignan, S<p><strong>Background:</strong> Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.</p> <p><strong>Aim:</strong> This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs.</p> <p><strong>Design and setting:</strong> An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England.</p> <p><strong>Method:</strong> PA consultations were compared with those of GPs. Primary outcome was re-consultation within 14 days for the same or linked problem. Secondary outcomes were processes of care.</p> <p><strong>Results:</strong> There were no significant differences in the rates of re-consultation (rate ratio 1.24, 95% confidence interval [CI] = 0.86 to 1.79, <em>P</em> = 0.25). There were no differences in rates of diagnostic tests ordered (1.08, 95% CI = 0.89 to 1.30, <em>P</em> = 0.44), referrals (0.95, 95% CI = 0.63 to 1.43, <em>P</em> = 0.80), prescriptions issued (1.16, 95% CI = 0.87 to 1.53, <em>P</em> = 0.31), or patient satisfaction (1.00, 95% CI = 0.42 to 2.36, <em>P</em> = 0.99). Records of initial consultations of 79.2% (<em>n</em> = 145) of PAs and 48.3% (<em>n</em> = 99) of GPs were judged appropriate by independent GPs (<em>P</em><0.001). The adjusted average PA consultation was 5.8 minutes longer than the GP consultation (95% CI = 2.46 to 7.1; <em>P</em><0.001); cost per consultation was GBP £6.22, (US$ 10.15) lower (95% CI = −7.61 to −2.46, <em>P</em><0.001).</p> <p><strong>Conclusion:</strong> The processes and outcomes of PA and GP consultations for same-day appointment patients are similar at a lower consultation cost. PAs offer a potentially acceptable and efficient addition to the general practice workforce.</p> |
| spellingShingle | Drennan, VM Halter, M Joly, L Gage, H Grant, RL Gabe, J Brearley, S Carneiro, W de Lusignan, S Physician associates and GPs in primary care: a comparison |
| title | Physician associates and GPs in primary care: a comparison |
| title_full | Physician associates and GPs in primary care: a comparison |
| title_fullStr | Physician associates and GPs in primary care: a comparison |
| title_full_unstemmed | Physician associates and GPs in primary care: a comparison |
| title_short | Physician associates and GPs in primary care: a comparison |
| title_sort | physician associates and gps in primary care a comparison |
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