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Replacing an Academic Internal Medicine Residency Program With a Physician Assistant–Hospitalist Model: A Comparative Analysis Study

¹ Coney Island Hospital, Brooklyn, New York
² North Bronx Healthcare Network, Bronx, New York

^* To whom correspondence should be addressed. E-mail: dhuper{at}yahoo.com.

	Abstract

This study describes a comparative analysis of replacing medical residents with physician assistants and hospitalists on patient outcomes in a community hospital. Prospective data during the physician assistants–hospitalists service for 2 years was compared with 2 years of retrospective data of the medical residents model. Outcome measures included mortality, adverse events, readmissions, and patient satisfaction. For physician assistants–hospitalists versus medical residents models, all-cause and case mix index–adjusted mortality was 107/5508 (1.94%) and 0.019 versus 156/5458 (2.85%) and 0.029, respectively (P .001). The adverse event cases were 9 versus 5 (P = .29), and the readmission rate within 30 days was 64 versus 69 (P = .34). Patient satisfaction was 95% versus 96% (P = .33). Quality of care provided by the physician assistants/ hospitalists model was equivalent. All-cause and case mix index–adjusted mortality was significantly lower during the physician assistants–hospitalists period. Although the application of these findings to other institutions requires further study, the authors found no intrinsic barriers that would impede implementation elsewhere. (Am J Med Qual XXXX;X:xx-xx)

First published on February 9, 2009, doi:10.1177/1062860608329646

American Journal of Medical Quality 2009;24:132.

A more recent version of this article appeared on March 1, 2009


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