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Economic Analysis of Physician Assistants in Ontario: Literature Review and Feasibility Study

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  • Amiram Gafni

    ()
    (Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University)

  • Stephen Birch

    ()
    (Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University)

  • Gioia Buckley

    ()
    (Centre for Health Economics and Policy Analysis, McMaster University)

Abstract

We conducted a literature review of studies on Physician Assistants working in a variety of settings and found few evaluation studies on the costs and/or effectiveness of Physician Assistants in primary care practices, Emergency Departments and in hospital settings other than Emergency Departments. The existing literature is limited because of the non-Canadian settings in which most studies have been performed and because of the non-experimental study designs, which are subject to potential bias. In addition, the research questions that have been addressed have tended to ignore what would appear to be the most important comparison: that between Physician Assistants and other non-physician providers such as Nurse Practitioners. The evidence we found on the cost-effectiveness of PAs is anecdotal and difficult to translate in the Ontario context. We conclude that it is difficult to make use of the existing literature. We recommend that MOHLTC consider options for funding a randomized control trial that might involve several trial arms in the particular sectors of relevance to the PA program, for example: physician only; physician and PA; physician and NP; and physician, NP and PA. The purpose of this would be to explore the difference in costs and effects on the different service modalities. This would also provide sufficient information to support modelling the short-run effects that could be expected from allocating the same amount of resources to the different service modalities as well as the implications for physician resources planning.

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File URL: http://www.chepa.org/docs/working-papers/chepa-wp-11-03.pdf
File Function: First version, 2011
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Bibliographic Info

Paper provided by Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada in its series Centre for Health Economics and Policy Analysis Working Paper Series with number 2011-03.

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Date of creation: 2011
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Handle: RePEc:hpa:wpaper:201103

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  1. Birch, Stephen & Gafni, Amiram, 2003. "Economics and the evaluation of health care programmes: generalisability of methods and implications for generalisability of results," Health Policy, Elsevier, vol. 64(2), pages 207-219, May.
  2. Denton, Frank T. & Gafni, Amiram & Spencer, Byron G. & Stoddart, Greg L., 1983. "Potential savings from the adoption of nurse practitioner technology in the Canadian health care system+," Socio-Economic Planning Sciences, Elsevier, vol. 17(4), pages 199-209.
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