title: Improving health care efficiency through the integration of a physician assistant into an infectious diseases consult service at a large urban community hospital.
abstract: BACKGROUND
  Physician assistants (PAs) have recently been introduced into the Canadian health care system in some provinces; however, there are little data demonstrating their impact.
  
  
  METHODS
  A retrospective case-control study was conducted between January 2010 and December 2013. Length of stay (LOS) and mortality were examined in the infectious diseases consult service (IDCS) compared with hospital-wide controls. The two-year period before the introduction of the PA to the IDCS of a large urban community hospital in Canada (2010 to 2011) was compared with the two-year period following the introduction of the PA (2012 to 2013).
  
  
  RESULTS
  Following the introduction of a PA to the IDCS, there was a decrease in time to consultation from 21.4 h to 14.3 h (P<0.0001). LOS was significantly decreased among IDCS patients by 3.6 days more than that seen in matched hospital-wide controls (P=0.0001). Mortality did not significantly change after PA introduction in either cases or controls.
  
  
  CONCLUSIONS
  PAs can improve health efficiencies in the Canadian health care setting, leading to reduction in LOS.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Physician Assistant Education Program, McMaster University, Hamilton, Ontario;
authors.forename: Melissa
authors.initials: M
authors.lastname: Decloe
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Department of Medicine, University of Toronto, Toronto, Ontario.
authors.forename: Janine
authors.initials: J
authors.lastname: McCready
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Department of Medicine, University of Toronto, Toronto, Ontario.
authors.forename: James
authors.initials: J
authors.lastname: Downey
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Toronto East General Hospital, Toronto; ; Department of Medicine, University of Toronto, Toronto, Ontario.
authors.forename: Jeff
authors.initials: J
authors.lastname: Powis
keywords: Length of stay; Mortality; Physician assistant