Master Physician Assistant Program, School of Health Care Studies, Hanze University of Applied Sciences, Groningen, Groningen, The Netherlands.
Hum Resour Health. 2012 Sep 4;10:28. doi: 10.1186/1478-4491-10-28.
The employment of physician assistants (PAs) is a strategy to improve access to care. Since the new millennium, a handful of countries have turned to PAs as a means to bridge the growing gap between the supply and demand of medical services. However, little is known about this new workforce entity from the patient's perspective. The objective of this study was to assess the willingness of Dutch patients to be treated by a PA or a medical doctor (MD) under various time constraints and semi-urgent medical scenarios.
A total of 450 Dutch adults were recruited to act as surrogate patients. A convenience sample was drawn from patients in a medical office waiting room in a general hospital awaiting their appointments. Each participant was screened to be naive as to what a PA and a nurse practitioner are and then read a definition of a PA and an MD. One of three medical scenarios was assigned to the participants in a patterned 1-2-3 strategy. Patients were required to make a trade-off decision of being seen after 1 hour by a PA or after 4 hours by a doctor. This forced-choice method continued with the same patient two more times with 30 minutes and 4 hours and another one of 2 hours versus 4 hours for the PA and MD, respectively.
Surrogate patients chose the PA over the MD 96 % to 98 % of the time (depending on the scenario). No differences emerged when analysed by gender, age, or parenthood status.
Willingness to be seen by a PA was tested a priori to determine whether surrogate Dutch patients would welcome this new health-care provider. The findings suggest that employing PAs, at least in concept, may be an acceptable strategy for improving access to care with this population.
医生助理（PA）的就业是改善医疗服务可及性的一种策略。自新千年以来，少数几个国家开始将 PA 作为弥合医疗服务供需差距的一种手段。然而，从患者的角度来看，人们对这个新的劳动力实体知之甚少。本研究的目的是评估荷兰患者在各种时间限制和半紧急医疗情况下，愿意接受 PA 或 MD 治疗的意愿。
共招募了 450 名荷兰成年人作为替代患者。在一家综合医院的医疗办公室候诊室，从等待预约的患者中抽取方便样本。对每个参与者进行筛选，使其对 PA 和护士从业者一无所知，然后阅读 PA 和 MD 的定义。参与者按照 1-2-3 策略中的模式被分配到三个医疗场景之一。要求患者在 1 小时后由 PA 或 4 小时后由医生进行就诊时做出取舍决策。这种强制选择方法继续对同一名患者进行了另外两次，分别为 30 分钟和 4 小时，然后是 PA 和 MD 分别为 2 小时和 4 小时。
替代患者 96%到 98%的时间选择 PA 而不是 MD（取决于场景）。在性别、年龄或父母身份方面，没有出现差异。
在确定替代荷兰患者是否欢迎这种新的医疗保健提供者之前，预先测试了他们接受 PA 治疗的意愿。研究结果表明，至少在概念上，雇用 PA 可能是改善该人群获得医疗服务的一种可接受策略。
