MICU care delivered by PAs versus residents: do PAs measure up?
BACKGROUND
Data on the perfomance of physician assistants in a medical intensive care unit are scarce.


OBJECTIVE
To compare clinical outcomes between patients admitted to a resident-run MICU and a PA-run MICU.


METHODS
Retrospective analysis of prospectively collected MICU data was performed for 5,346 patients admitted to an MICU from January 2004 through January 2007; 3,971 patients were admitted to a resident-run MICU (resident group) and 1,375 to a PA-run MICU (PA group).


RESULTS
The groups were relatively similar, though the resident group had a higher rate of renal insufficiency (25% vs. 22%, P = .05) and the PA group had a higher rate of cerebrovascular accidents (5.6% vs. 4%, P = .02). Hospital length of stay (LOS) was similar, with a median of 9 days in the PA group and 8 days in the resident group (P = .59). MICU LOS was slightly longer for the PA group: a median of 2.58 days (1.55-4.86) vs. 2.33 days (1.39-4.16) in the resident group. After matching by propensity score, we could not confirm this increased LOS. There was no difference in hospital mortality or in ICU mortality between the two groups either in uncontrolled or controlled analyses. Survival analyses showed no difference in 28-day survival between the two groups.


CONCLUSIONS
A PA-run MICU has similar outcomes when compared to a resident-run MICU.
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Eyad
E
Kawar
Bruno
B
DiGiovine
D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D007396:Internship and Residency; D007902:Length of Stay; D008297:Male; D008824:Michigan; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010823:Physician Assistants; D010820:Physicians; D012189:Retrospective Studies