The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.

<h4>Background</h4>The global utilization of the physician assistant/associate (PA) is growing. Their increasing presence is in response to the rising demands of demographic changes, new developments in healthcare, and physician shortages. While PAs are present on four continents, the ev...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	G T W J van den Brink, R S Hooker, A J Van Vught, H Vermeulen, M G H Laurant
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9219047d2ef24d37a90f77abc348f7dd
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:9219047d2ef24d37a90f77abc348f7dd
record_format	dspace
spelling	oai:doaj.org-article:9219047d2ef24d37a90f77abc348f7dd2021-12-02T20:04:35ZThe cost-effectiveness of physician assistants/associates: A systematic review of international evidence.1932-620310.1371/journal.pone.0259183https://doaj.org/article/9219047d2ef24d37a90f77abc348f7dd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259183https://doaj.org/toc/1932-6203<h4>Background</h4>The global utilization of the physician assistant/associate (PA) is growing. Their increasing presence is in response to the rising demands of demographic changes, new developments in healthcare, and physician shortages. While PAs are present on four continents, the evidence of whether their employment contributes to more efficient healthcare has not been assessed in the aggregate. We undertook a systematic review of the literature on PA cost-effectiveness as compared to physicians. Cost-effectiveness was operationalized as quality, accessibility, and the cost of care.<h4>Methods and findings</h4>Literature to June 2021 was searched across five biomedical databases and filtered for eligibility. Publications that met the inclusion criteria were categorized by date, country, design, and results by three researchers independently. All studies were screened with the Risk of Bias in Non-randomised Studies-of Interventions (ROBIN-I) tool. The literature search produced 4,855 titles, and after applying criteria, 39 studies met inclusion (34 North America, 4 Europe, 1 Africa). Ten studies had a prospective design, and 29 were retrospective. Four studies were assessed as biased in results reporting. While most studies included a small number of PAs, five studies were national in origin and assessed the employment of a few hundred PAs and their care of thousands of patients. In 34 studies, the PA was employed as a substitute for traditional physician services, and in five studies, the PA was employed in a complementary role. The quality of care delivered by a PA was comparable to a physician's care in 15 studies, and in 18 studies, the quality of care exceeded that of a physician. In total, 29 studies showed that both labor and resource costs were lower when the PA delivered the care than when the physician delivered the care.<h4>Conclusions</h4>Most of the studies were of good methodological quality, and the results point in the same direction; PAs delivered the same or better care outcomes as physicians with the same or less cost of care. Sometimes this efficiency was due to their reduced labor cost and sometimes because they were more effective as producers of care and activity.G T W J van den BrinkR S HookerA J Van VughtH VermeulenM G H LaurantPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259183 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q G T W J van den Brink R S Hooker A J Van Vught H Vermeulen M G H Laurant The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
description	<h4>Background</h4>The global utilization of the physician assistant/associate (PA) is growing. Their increasing presence is in response to the rising demands of demographic changes, new developments in healthcare, and physician shortages. While PAs are present on four continents, the evidence of whether their employment contributes to more efficient healthcare has not been assessed in the aggregate. We undertook a systematic review of the literature on PA cost-effectiveness as compared to physicians. Cost-effectiveness was operationalized as quality, accessibility, and the cost of care.<h4>Methods and findings</h4>Literature to June 2021 was searched across five biomedical databases and filtered for eligibility. Publications that met the inclusion criteria were categorized by date, country, design, and results by three researchers independently. All studies were screened with the Risk of Bias in Non-randomised Studies-of Interventions (ROBIN-I) tool. The literature search produced 4,855 titles, and after applying criteria, 39 studies met inclusion (34 North America, 4 Europe, 1 Africa). Ten studies had a prospective design, and 29 were retrospective. Four studies were assessed as biased in results reporting. While most studies included a small number of PAs, five studies were national in origin and assessed the employment of a few hundred PAs and their care of thousands of patients. In 34 studies, the PA was employed as a substitute for traditional physician services, and in five studies, the PA was employed in a complementary role. The quality of care delivered by a PA was comparable to a physician's care in 15 studies, and in 18 studies, the quality of care exceeded that of a physician. In total, 29 studies showed that both labor and resource costs were lower when the PA delivered the care than when the physician delivered the care.<h4>Conclusions</h4>Most of the studies were of good methodological quality, and the results point in the same direction; PAs delivered the same or better care outcomes as physicians with the same or less cost of care. Sometimes this efficiency was due to their reduced labor cost and sometimes because they were more effective as producers of care and activity.
format	article
author	G T W J van den Brink R S Hooker A J Van Vught H Vermeulen M G H Laurant
author_facet	G T W J van den Brink R S Hooker A J Van Vught H Vermeulen M G H Laurant
author_sort	G T W J van den Brink
title	The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
title_short	The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
title_full	The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
title_fullStr	The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
title_full_unstemmed	The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.
title_sort	cost-effectiveness of physician assistants/associates: a systematic review of international evidence.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9219047d2ef24d37a90f77abc348f7dd
work_keys_str_mv	AT gtwjvandenbrink thecosteffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT rshooker thecosteffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT ajvanvught thecosteffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT hvermeulen thecosteffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT mghlaurant thecosteffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT gtwjvandenbrink costeffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT rshooker costeffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT ajvanvught costeffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT hvermeulen costeffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence AT mghlaurant costeffectivenessofphysicianassistantsassociatesasystematicreviewofinternationalevidence
_version_	1718375556684185600

The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.

Ejemplares similares