Study: analysis | Main finding: PA performance vs primary care physicians | Patient cohort seen by PAs vs primary care physicians | Covariates included in adjusted analyses |
---|---|---|---|
Diagnostic tests ordered | |||
 Drennan et al., 2015 [21]: Diagnostic tests (no specific ones specified) | ↔ No significant difference Rate ratio 1.08 (0.89–1.30) | - Younger - From different geographical areas - Healthier/lower healthcare use | Age, acuity of presenting problem, sex, practice attendances in the previous 3 months, no. problems, chronic disease registers, socioeconomic deprivation |
 Hughes et al., 2015 [23]: Imaging | ↑ Higher use Adjusted OR 1.34 (1.27–1.42) a) | - Younger - higher % female - higher % of white ethnicity - Healthier - From different geographical areas | Patient age group, sex, race, state, urban, comorbidity. |
 Kurtzman et al., 2017 [26]: Imaging | ↔ No significant difference Adjusted OR 1.14 (0.84–1.54) | Similar (age, gender, ethnicity, payer source) to PCPs. | Age, sex, race, ethnicity, payer, metro status, region, reason for visit, health centre type, education, year. |
 Mafi et al., 2016 [29] - Radiography (in ‘low value’ cases) b) | ↔ No significant difference 10.2 in PCP vs 11.4 in PAs (alone), p = 0.71 and 9.5% in PAs (shared) p = 0.75 | - Younger - From different geographical areas | Patient age, sex, race or ethnicity, comorbidity, symptom acuity, insurance status, urban location, geographic region, year |
- CT or MRI (in ‘low value’ cases) | ↔ No significant difference 6.0 in PCP vs 9.9 in PAs (alone), p = 0.3 and 6.8% in PAs (shared) p = 0.69 | ||
Referrals to other physicians | |||
 Drennan et al., 2015 [21] | ↔ No significant difference Rate ratio 0.95 9 (0.63–1.43) p = 0.80 | - Younger - From different geographical areas - Healthier/lower healthcare use | Age, acuity of presenting problem, sex, # practice attendances in the previous 3 months, # problems, # chronic disease registers, socioeconomic deprivation |
 Kurtzman et al., 2017 [26] | ↔ No significant difference Adjusted OR 1.17 (0.87–1.56) | PAs saw similar patient profile (age, gender, ethnicity, payer source) to PCPs. | Age, sex, race, ethnicity, payer, metro status, region, reason for visit, health centre type, education, year. |
 Mafi et al., 2016 [29]: Situations in which referral considered to be low value | ↔ No significant difference 8.2 in PCP vs 5.9 in PAs (alone), p = 0.52 and 8.6% in PAs (shared) p = 0.86 | - Younger - From different geographical areas | Patient age, sex, race or ethnicity, comorbidity, symptom acuity, insurance status, urban location, geographic region, and year |
Screening | |||
 Tang et al., 2016 [31]: PSA screening rates for patients with limited life expectancy | ↔ No significant difference c) Screening offered in 41.3% of cases by PAs vs 41.5% by PCPs | Not reported | Patient age, race, marital status, income, education, clinician clustering |
Outcomes | |||
 Brock et al., 2017 [19]: Malpractice reports per 1000 clinicians d): diagnosis related claims comprise diagnosis failure or delay in diagnosis | ↓ Lower payments Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs | No data but differences in breadth of patient acuity proposed as possible explanation for findings. | n/a |
 Drennan et al., 2015 [21] - Re-consultation within 14 days for the same or a linked problem - Patient Satisfaction e) | ↔ No significant difference Adjusted rate ratio 1.24 (0.86–1.79), p = 0.25 | - Younger - From different geographical areas - Healthier/lower healthcare use | Age, acuity of presenting problem, sex, # practice attendances in the previous 3 months, # problems, # chronic disease registers, socioeconomic deprivation |
↔ No significant difference Adjusted rate ratio 1.00 (0.42–2.36), p = 0.99 | |||
Kurtzman et al., 2017 [26]: Re-consultation | ↔ No significant difference Adjusted odds ratio 0.77(.52–1.13) | PAs saw similar patient profile (age, gender, ethnicity, payer source) to PCPs. | Age, sex, race, ethnicity, payer, metro status, region, reason for visit, health center type, education, year. |