The (Cost-)Effectiveness of Physician Assistants Working at the Primary Out of Hours Emergency Service

NCT02417181 | Completed

• 1 other identifier: PA_in_spoedzorg
• Study Type: interventional
• Target: 10,161
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to explore the effect of substituting General Practitioners (GPs) by Physician Assistants (PAs) in out-of-hours primary care. Effects are measured in terms of the implication for the care model, quality of care delivered by PAs in comparison to GPs; the complaints treated by PAs in comparison to GPs; safety, efficiency and patient satisfaction. Lastly, this study will provide insight in the changes in costs of healthcare.

Conditions

Primary Healthcare; Out-of-hours Medical Care

Keywords

Physician assistants; Out-of-hours medical care; Primary healthcare; Emergency Medical Services

Outcome Measures

Primary Outcomes (2)

• Number of patients

  To measure substitution of healthcare, the number of consultations in the experimental and control group and per discipline will be measured. These data will be derived from the electronic medical records.

  18 months

• Patient characteristics (composite)

  Patient characteristics of patients seen in the experimental and control group and per discipline include age, gender, urgency and type of complaint. These data will be derived from the electronic medical records.

  18 months

Secondary Outcomes (6)

• The number of prescriptions; number of test & investigations ordered and referral to the emergency department

  18 months

• Direct healthcare costs related to care provide by PAs and GPs will be calculated.

  18 months

• Adherence to the practice guidelines for General Practitioners

  6 months

• Amount of adverse events and complications

  18 months

• Patient satisfaction questionaire

  6 months

Study Arms (2)

General Practitioners Care

NO INTERVENTION

Usual medical care provided by a general practitioner at the out-of-hours primary care service

Physician Assistants Care

EXPERIMENTAL

Medical care provided by the Physician Assistant at the out-of-hours primary care service

Other: Care provided by Physician Assistants

Interventions

Care provided by Physician Assistants OTHER

Patients will receive care at the out-of-hours primary care service by a Physician Assistant instead of a General Practitioner (substitution of care from physicians to nurses).

Physician Assistants Care

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients (with urgency U2, U3, U4, or U5) requesting an appointment at the primary out of hours emergency service during the weekend between 9.00 and 17.00 hours.

You may not qualify if:

• None

Sponsors & Collaborators

• Radboud University Medical Center: lead
• Stichting Kwaliteit en Ontwikkeling Huisartsenzorg: collaborator
• GP Cooperative Emmen (CHD Emmen): collaborator

Study Sites (1)

Centrale Huisartsendienst Drenthe

Emmen, 7824 AA, Netherlands

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 31, 2015
• First Posted: April 15, 2015
• Study Start: April 1, 2014
• Primary Completion: January 1, 2016
• Study Completion: January 1, 2016
• Last Updated: April 7, 2016

Record last verified: 2016-04

Locations

NL (1)