Chumbler N R, Weier A W, Geller J M
North Florida/South Georgia Veterans Health System, Gainesville, USA.
J Allied Health. 2001 Spring;30(1):2-10.
The practice autonomy of primary care physician assistants (PAs) is of interest to those organizing, financing, and delivering health services. This study examined the predictive abilities of practice attributes with respect to multidimensional aspects of practice autonomy (clinical decision making and prescriptive authority) in primary care PAs. A sample of 225 practicing PAs was used to construct the 16-item Physician Assistant Autonomy of Practice Instrument (PAAPI), which includes three subscales, routine prescriptive authority, advanced prescriptive authority, and clinical decision making. All were used as dependent variables in multiple regression analyses. The most significant correlates of practice autonomy included years in practice as a PA, years in practice with supervising physician, annual income from practice, recognition as the exclusive primary care provider for patients, primary practice in a rural county, and primary employment setting (single-specialty group practice). More primary care PAs continue to be used in under-served rural areas and in managed care. Organizational structure of the work setting may influence these PAs' practice autonomy.
基层医疗医师助理（PA）的执业自主权受到那些组织、资助和提供医疗服务的人的关注。本研究考察了执业属性对基层医疗PA执业自主权多维度方面（临床决策和处方权）的预测能力。采用225名执业PA的样本构建了包含16个条目的医师助理执业自主权量表（PAAPI），该量表包括三个子量表，即常规处方权、高级处方权和临床决策。在多元回归分析中，所有这些都用作因变量。执业自主权最显著的相关因素包括担任PA的执业年限、与指导医师的执业年限、执业年收入、被认可为患者唯一的基层医疗服务提供者、在农村县的基层医疗执业以及主要就业环境（单一专科团体执业）。更多的基层医疗PA继续被用于服务不足的农村地区和管理式医疗中。工作环境的组织结构可能会影响这些PA的执业自主权。
