Impact of physician assistant care on office visit resource use in the United States.

摘要

To investigate whether the use of physician assistants (PAs) as providers for a substantive portion of a patient's office-based visits affects office visit resource use.Medical Expenditure Panel Survey (MEPS) Household Component data from 1996 to 2004.This retrospective cohort study compares the number of office-based visits per year between adults for whom PAs provided >or=30 percent of visits and adults cared for by physicians only.The Agency for Healthcare Research and Quality collects MEPS data using methods designed to produce data representative of the U.S. noninstitutionalized civilian population. Negative binomial regression was used to compare the number of visits per year between persons with and without PA care, adjusted for demographic, geographic, and socioeconomic factors; insurance status; health status; and medical conditions.After case-mix adjustment, patients for whom PAs provided a substantive portion of care used about 16 percent fewer office-based visits per year than patients cared for by physicians only. This difference in the use of office-based visits was not offset by increased office visit resource use in other settings.Results indicate that the inclusion of PAs in the U.S. provider mix does not affect overall office visit resource use.