Department of Pediatrics School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Emerg Med Australas. 2011 Feb;23(1):7-15. doi: 10.1111/j.1742-6723.2010.01368.x. Epub 2011 Jan 20.
This systematic review describes the role and impact of physician assistants (PAs) in the ED. It includes reports of surveys, retrospective and prospective studies as well as guidelines and reviews. Seven hundred and twelve studies were identified of which only 66 were included, and many of these studies were limited by methodological quality. Generally the use of PAs in the ED is modest with 13-18% of US EDs having PAs although academic medical centres report PA use in 65-68% of EDs. The evidence indicates that PAs are reliable in assessing certain medical complaints and performing procedures, and are well accepted by ED staff and patients alike. There is limited evidence as to whether PAs improve ED flow or are cost-effective. Future studies on work processes, cost-effectiveness, unfamiliar patients' willingness to be treated by non-physician providers, and ED physicians' acceptability of PAs are needed to inform and guide the integration of PAs into EDs.
这篇系统综述描述了医师助理（PA）在急诊科中的角色和影响。它包括调查报告、回顾性和前瞻性研究以及指南和综述。共确定了 712 项研究，但仅纳入了 66 项，其中许多研究受到方法学质量的限制。通常，PA 在急诊科的使用量适中，美国有 13-18%的急诊科使用 PA，而学术医疗中心报告称，65-68%的急诊科使用 PA。证据表明，PA 可靠地评估某些医疗投诉和进行操作，并且得到了急诊科工作人员和患者的广泛认可。关于 PA 是否改善 ED 流程或具有成本效益的证据有限。需要进一步研究工作流程、成本效益、非医师提供者对不熟悉患者的治疗意愿以及 ED 医生对 PA 的接受程度，以提供信息并指导将 PA 纳入 ED。
