Department of Emergency Medicine, St Luke's Hospital and Health Network, 801 Ostrum St, Bethlehem, PA 18015, USA.
Emerg Med J. 2013 Jan;30(1):e12. doi: 10.1136/emermed-2011-200572. Epub 2012 Mar 12.
To evaluate productivity of mid-level providers (MLPs) compared with emergency medicine (EM) resident physicians in an emergency department (ED) low acuity area, and to compare patient satisfaction when cared for by MLPs versus EM residents.
This was a retrospective review of EM resident physicians and MLPs in an ED low acuity area. The number of patients seen and relative value units (RVUs) generated per clinical hour worked were evaluated. A t test was used to compare resident and MLP productivity. Additionally, patients were prospectively surveyed to assess satisfaction, using survey items based on the Press-Ganey survey. Non-parametric statistics were used to analyse patient satisfaction scores.
MLPs treated 2.21 patients per hour (CI ±0.09), while resident physicians treated 1.53 patients per hour (CI ±0.08). MLPs generated 4.01 RVUs per hour (CI ±0.18) while resident physicians generated 3.14 RVUs per hour (CI ±0.18). Resident physicians generated 2.07 RVUs per patient (CI ±0.08) while MLPs generated 1.82 RVUs per patient (CI ±0.03; p<0.001). Of the 201 completed satisfaction surveys, 126 patients were seen by MLPs and 75 were seen by residents. Overall patients were highly satisfied with their ED visit. There were no differences in any survey responses based on provider type or resident level of training.
In a low acuity area of the ED, MLPs treated more patients per hour and generated more RVUs per hour than EM resident physicians. However, resident physicians generated more RVUs per patient. Patient satisfaction did not differ.
评估中级医疗提供者（MLP）在急诊部（ED）低 acuity 区域的生产力与急诊医学（EM）住院医师相比，并比较由 MLP 与 EM 住院医师护理的患者的满意度。
这是对 ED 低 acuity 区域的 EM 住院医师和 MLP 进行的回顾性研究。评估了每临床小时工作所看患者的数量和相对价值单位（RVU）。使用 t 检验比较住院医师和 MLP 的生产力。此外，通过使用基于 Press-Ganey 调查的调查项目，前瞻性调查患者以评估满意度。使用非参数统计分析患者满意度评分。
MLP 每小时治疗 2.21 名患者（CI ±0.09），而住院医师每小时治疗 1.53 名患者（CI ±0.08）。MLP 每小时生成 4.01 RVUs（CI ±0.18），而住院医师每小时生成 3.14 RVUs（CI ±0.18）。住院医师每患者生成 2.07 RVUs（CI ±0.08），而 MLP 每患者生成 1.82 RVUs（CI ±0.03；p<0.001）。在 201 份完成的满意度调查中，有 126 名患者由 MLP 治疗，75 名患者由住院医师治疗。总体而言，患者对他们的 ED 就诊非常满意。基于提供者类型或住院医师的培训水平，在任何调查响应中均未发现差异。
在 ED 的低 acuity 区域，MLP 每小时治疗的患者更多，每小时生成的 RVU 更多，而 EM 住院医师每患者生成的 RVU 更多。然而，住院医师每患者生成的 RVU 更多。患者满意度没有差异。
