R J Ackermann1, K A Kemle. 1. Department of Family and Community Medicine, Mercer University School of Medicine, and the Medical Center of Central Georgia, Macon, USA.
Abstract
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.
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.
Authors: Orna Intrator; David C Grabowski; Jacqueline Zinn; Mark Schleinitz; Zhanlian Feng; Susan Miller; Vince Mor Journal: Health Serv Res Date: 2007-08 Impact factor: 3.402
Authors: Kenneth S Boockvar; Ann L Gruber-Baldini; Bruce Stuart; Sheryl Zimmerman; Jay Magaziner Journal: J Am Geriatr Soc Date: 2008-05-12 Impact factor: 5.562
Authors: Marleen H Lovink; Anneke J A H van Vught; Anke Persoon; Raymond T C M Koopmans; Miranda G H Laurant; Lisette Schoonhoven Journal: Nurs Health Sci Date: 2019-04-01 Impact factor: 1.857