Commentaries on health services research

Medical care for hospitalized patients is increasingly allocated to PAs, yet there is limited evidence about the quality and safety of care. In a multicenter matched-controlled study, the traditional model in which only physicians are employed for inpatient care was compared with a mixed model employing physicians and PAs. Patients were followed from admission until 1 month after discharge. The primary outcome measure was patient length of stay (LOS). Secondary outcomes concerned 11 indicators for quality and safety of inpatient care and patients' experiences with the provided care. Data on 2,307 patients from 34 hospital units were analyzed. The involvement of PAs was not signifi cantly associated with LOS. None of the indicators for quality and safety of care were different between the two study arms. However, the involvement of PAs was associated with better patient experiences. No differences in LOS and quality of care were found between units on which PAs, in collaboration with physicians, provided medical care for the admitted patients, and units on which only physicians provided medical care. Employing PAs seems to lead to better inpatient experiences.