The effect of a physician assistant on the hospitalization of nursing home residents

J Am Geriatr Soc. 1998 May;46(5):610-4. doi: 10.1111/j.1532-5415.1998.tb01078.x.


Objectives: To describe the impact of regular visits to a nursing home by a gerontologist physician assistant (PA) on the hospitalization and medical costs of patients.

Design: A 6-year case series (1992-1997) incorporating events before and after introduction of a PA in May 1994. The PA visited the nursing home 3 to 4 times per week, provided nearly all of the acute medical care, and alternated routine visits with supervising physicians.

Setting: A 92-bed teaching nursing home in central Georgia.

Measurements: Demographics of the nursing home population; hospitalizations of residents, including major diagnosis and length of stay; number and site of all resident deaths; costs of physician and PA services and hospital costs.

Results: After the introduction of the physician assistant, the number of annual hospital admissions fell by 38.0%, and the total number of hospital days per 1000 patient years fell by 68.6% (from 4170 in 1992 to 1310 in 1997). The number of nursing home visits increased by 62.1%. Annual Medicare-allowed charges for MD and PA services increased by $22,304, but this was more than offset by a decline in hospital DRG reimbursements of $96,043.

Conclusions: The introduction of regular visits to nursing home patients by a physician assistant can reduce hospitalization and medical costs of these frail older people.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Costs and Cost Analysis
  • Female
  • Frail Elderly*
  • Geriatrics*
  • Hospitalization
  • Hospitals / statistics & numerical data*
  • Humans
  • Length of Stay
  • Male
  • Medicare / economics
  • Mortality
  • Nursing Homes* / economics
  • Physician Assistants* / economics
  • United States