Physician assistants can cut hospitalist program costs

Doctor patient
Doctor and patient.

Hospitalist programs have been used as a way to more efficiently deliver healthcare in the hospital setting for decades now. But the way an organization deploys personnel in a hospitalist program can make a difference in terms of cost and patient outcomes.

That’s the conclusion of researchers from Anne Arundel Medical Center and an affiliated medical group in Maryland. Writing in the Journal of Clinical Outcomes Management, they noted that the use of physician assistants (PAs) in some hospitalist support positions made a little difference in outcomes while cutting costs.

For the study, the researchers compared the outcomes of a hospitalist group of six clinicians equally split between physicians and PAs, versus an 11-member group consisting of nine physicians and two PAs. Both physicians and physician assistants engaged in patient rounding, but in the equally staffed groups, the PAs saw 14 patients per day. In the group where physicians predominated, the PAs saw nine patients per day. Their work was performed at a 384-bed community hospital, with nearly 17,000 discharges occurring between early 2012 and mid-2013.

Readmissions and patient mortality among the group with an equal number of PAs was slightly higher than the other group, although the study said the difference was not statistically significant.

However, there was a significant difference among patient charges. With the equalized PA group, their unadjusted mean was in a range between $7,755 and $7,822, while the group where physicians were the larger number saw costs ranging between $8,307 and $10,034.

The number of PAs in the United States has been growing rapidly, with one study released earlier this year suggesting their ranks have grown by as much as 35 percent over the past five years.

More savings could also be had in terms of personnel. “As the median salary for a PA hospitalist is $102,960 compared with the median internal medicine physician hospitalist salary of $253,977, using hospitalist PAs in a collaboration model...could result in significant savings for supporting institutions without sacrificing quality,” the study concluded.