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Thursday, March 11, 2004

PAs can deliver service at lower cost

By Nancy Fehr

The economics of graduate medical education has received national attention; the cost of training residents has been controversial. According to researchers in Poster Exhibit 072, physician assistants (PA) deliver the same quality of service at a lower cost in performing joint replacements. This is the first study of the economic impact of physician assistants in orthopaedic surgery.

The study assessed resource consumption in an arthroplasty practice, using a prospective observational cohort of 194 consecutive patients who underwent arthroplasty. All the surgeries were performed in the same hospital by the same surgeon:

Both services were supervised by the senior author. True costs were obtained from a cost accounting software system available at the institution, and diagnosis, length of stay, age and insurance were collected for each patient. Non-parametric Mann-Whitney Test was utilized to analyze the data. A p<0.05 was considered significant.

The results show a significant increase in cost for patients cared for by a resident service, when compared to a PA based system, according to researchers. Socioeconomic implications of the finding may be important in planning resource allocation when developing ways to pay for graduate medical education, they noted.

Researchers included Carlos J. Lavernia, MD; Victor Hugo Hernandez; Rodrigo M. Diaz, MD; David Lee, MD; Michele R. Dapuzzo, MD, and Enrique Roig, PA-C. The group is part of the Orthopaedic Institute at Mercy Hospital, Miami, Fla.

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Last modified 01/March/2004