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MICU care delivered by PAs versus residents: do PAs measure up?
MedLine Citation:
PMID:  21261146     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Data on the perfomance of physician assistants in a medical intensive care unit are scarce.
OBJECTIVE: To compare clinical outcomes between patients admitted to a resident-run MICU and a PA-run MICU.
METHODS: Retrospective analysis of prospectively collected MICU data was performed for 5,346 patients admitted to an MICU from January 2004 through January 2007; 3,971 patients were admitted to a resident-run MICU (resident group) and 1,375 to a PA-run MICU (PA group).
RESULTS: The groups were relatively similar, though the resident group had a higher rate of renal insufficiency (25% vs. 22%, P = .05) and the PA group had a higher rate of cerebrovascular accidents (5.6% vs. 4%, P = .02). Hospital length of stay (LOS) was similar, with a median of 9 days in the PA group and 8 days in the resident group (P = .59). MICU LOS was slightly longer for the PA group: a median of 2.58 days (1.55-4.86) vs. 2.33 days (1.39-4.16) in the resident group. After matching by propensity score, we could not confirm this increased LOS. There was no difference in hospital mortality or in ICU mortality between the two groups either in uncontrolled or controlled analyses. Survival analyses showed no difference in 28-day survival between the two groups.
CONCLUSION: A PA-run MICU has similar outcomes when compared to a resident-run MICU.
Authors:
Eyad Kawar; Bruno DiGiovine
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAAPA : official journal of the American Academy of Physician Assistants     Volume:  24     ISSN:  1547-1896     ISO Abbreviation:  JAAPA     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513102     Medline TA:  JAAPA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-41     Citation Subset:  T    
Affiliation:
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
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