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Physician associates and GPs in primary care: a comparison.

Drennan, VM; Halter, M; Joly, L; Gage, H; Grant, RL; Gabe, J; Brearley, S; Carneiro, W; de Lusignan, S (2015) Physician associates and GPs in primary care: a comparison. Br J Gen Pract, 65 (634). e344-e350. ISSN 1478-5242 https://doi.org/10.3399/bjgp15X684877
SGUL Authors: Drennan, Vari MacDougal

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Abstract

BACKGROUND: Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice. AIM: This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs. DESIGN AND SETTING: An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England. METHOD: 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. RESULTS: There were no significant differences in the rates of re-consultation (rate ratio 1.24, 95% confidence interval [CI] = 0.86 to 1.79, P = 0.25). There were no differences in rates of diagnostic tests ordered (1.08, 95% CI = 0.89 to 1.30, P = 0.44), referrals (0.95, 95% CI = 0.63 to 1.43, P = 0.80), prescriptions issued (1.16, 95% CI = 0.87 to 1.53, P = 0.31), or patient satisfaction (1.00, 95% CI = 0.42 to 2.36, P = 0.99). Records of initial consultations of 79.2% (n = 145) of PAs and 48.3% (n = 99) of GPs were judged appropriate by independent GPs (P<0.001). The adjusted average PA consultation was 5.8 minutes longer than the GP consultation (95% CI = 2.46 to 7.1; P<0.001); cost per consultation was GBP £6.22, (US$ 10.15) lower (95% CI = -7.61 to -2.46, P<0.001). CONCLUSION: 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.

Item Type: Article
Additional Information: © British Journal of General Practice 2015 This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: general practitioners, observational study, physician assistants, physicians, family, primary health care, Adult, Appointments and Schedules, England, Female, Humans, Male, Patient Satisfaction, Physician Assistants, Primary Health Care, Retrospective Studies, State Medicine, Humans, Retrospective Studies, Adult, Physician Assistants, State Medicine, Appointments and Schedules, Patient Satisfaction, Primary Health Care, England, Female, Male, general practitioners, observational study, physician assistants, physicians, family, primary health care, Public Health, 1117 Public Health And Health Services
Journal or Publication Title: Br J Gen Pract
ISSN: 1478-5242
Language: eng
Dates:
DateEvent
May 2015Published
27 April 2015Published Online
5 January 2015Accepted
Publisher License: Creative Commons: Attribution 3.0
Projects:
Project IDFunderFunder ID
09/1801/1066Department of HealthUNSPECIFIED
PubMed ID: 25918339
Web of Science ID: WOS:000356966300008
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109439
Publisher's version: https://doi.org/10.3399/bjgp15X684877

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