A Multicenter Research on the Effects of Substitution of Hospital Ward Care From Medical Doctors to Physician Assistants
NCT ID: NCT01835444
Last Updated: 2015-05-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
2382 participants
OBSERVATIONAL
2013-04-30
2015-05-31
Brief Summary
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This multicenter matched-controlled study aims to evaluate the (cost) effectiveness of substitution of hospital ward care from medical doctors (MDs) to PAs. The traditional model in which the role of house officer is taken by medical doctors MD model) will be compared with a mixed model in which a PA functions as house officer together with a medical doctor (PA/MD model). Hospital wards will be matched on medical specialism and hospital type (i.e. academic;non-academic). On the basis of USA studies, it is hypothesized that the mixed PA/MD model compared to the MD model reduces the costs of healthcare, while improving or maintaining the clinical outcomes, patients and provider satisfaction, and continuity and quality of care.
Primary research question:
• What is the effect of 'mixed PA/MD model' compared with 'MD model' on efficiency of care?
Secondary research questions:
* What is the effect of 'mixed PA/MD model' compared with 'MD model' on clinical and patients outcomes?
* What is the effect of 'mixed PA/MD model' compared with 'MD model' on continuity of care?
* What is the effect of 'mixed PA/MD model' compared with 'MD model' on nurses and (specialist) medicals doctor experiences?
* What are the barriers and facilitating factors considering the implementation of PAs as house officer?
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Detailed Description
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Conditions
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Study Design
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PROSPECTIVE
Study Groups
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MD model
Hospital wards at which ward care is provided only by Medical Doctors (MDs)
No interventions assigned to this group
PA/MD model
Hospital wards at which ward care is provided by both Physician Assistants (PAs) and Medical Doctors (MDs)
PA/MD model
Intervention wards are hospital wards at which ward care is provided by both Physician Assistants (PAs) and Medical Doctors (MDs)
Interventions
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PA/MD model
Intervention wards are hospital wards at which ward care is provided by both Physician Assistants (PAs) and Medical Doctors (MDs)
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* Wards with only PAs in training
* Wards with a nurse practitioner (NP) in the role of house officer (NP, NP/MD or PA/NP/MD model)
* Pediatric and psychiatric wards, intensive care units
* Terminal patients
* Not fluent in Dutch language
* Age \< 18 years
* Patients in daycare
18 Years
ALL
No
Sponsors
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ZonMw: The Netherlands Organisation for Health Research and Development
OTHER
Radboud University Medical Center
OTHER
Responsible Party
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Principal Investigators
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M.G.H. Laurant, PhD
Role: PRINCIPAL_INVESTIGATOR
IQ healthcare, UMC St Radboud
Locations
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Scheper Ziekenhuis
Emmen, Drenthe, Netherlands
Gelre Ziekenhuizen
Apeldoorn, Gelderland, Netherlands
Rijnstate
Arnhem, Gelderland, Netherlands
Slingeland Ziekenhuis
Doetinchem, Gelderland, Netherlands
Ziekenhuis de Gelderse Vallei
Ede, Gelderland, Netherlands
Radboud University Nijmegen Medical Centre
Nijmegen, Gelderland, Netherlands
Canisius Wilhelmina ziekenhuis
Nijmegen, Gelderland, Netherlands
Streekziekenhuis Koningin Beatrix
Winterswijk, Gelderland, Netherlands
Laurentius Ziekenhuis
Roermond, Limburg, Netherlands
Laurentius Ziekenhuis
Roermond, Limburg, Netherlands
Orbis Medisch Centrum
Sittard, Limburg, Netherlands
VieCuri Medical Center
Venlo, Limburg, Netherlands
Jeroen Bosch Ziekenhuis
's-Hertogenbosch, North Brabant, Netherlands
Lievensberg Ziekenhuis
Bergen op Zoom, North Brabant, Netherlands
Elkerliek ziekenhuis
Helmond, North Brabant, Netherlands
Fransiscus Ziekenhuis
Roosendaal, North Brabant, Netherlands
St. Elisabeth Ziekenhuis
Tilburg, North Brabant, Netherlands
TweeSteden Ziekenhuis
Tilburg, North Brabant, Netherlands
Tjongerschans ziekenhuis
Heerenveen, Provincie Friesland, Netherlands
Reinier de Graaf Gasthuis
Delft, South Holland, Netherlands
HagaZiekenhuis
The Hague, South Holland, Netherlands
Medisch Centrum Haaglanden
The Hague, South Holland, Netherlands
UMC Utrecht
Utrecht, Utrecht, Netherlands
Van Weel Bethesda Ziekenhuis
Dirksland, Zeeland, Netherlands
Countries
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References
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Timmermans MJC, van Vught AJAH, Peters YAS, Meermans G, Peute JGM, Postma CT, Smit PC, Verdaasdonk E, de Vries Reilingh TS, Wensing M, Laurant MGH. The impact of the implementation of physician assistants in inpatient care: A multicenter matched-controlled study. PLoS One. 2017 Aug 9;12(8):e0178212. doi: 10.1371/journal.pone.0178212. eCollection 2017.
Timmermans MJC, van den Brink GT, van Vught AJAH, Adang E, van Berlo CLH, Boxtel KV, Braunius WW, Janssen L, Venema A, van den Wildenberg FJ, Wensing M, Laurant MGH. The involvement of physician assistants in inpatient care in hospitals in the Netherlands: a cost-effectiveness analysis. BMJ Open. 2017 Jul 10;7(7):e016405. doi: 10.1136/bmjopen-2017-016405.
Timmermans MJ, van Vught AJ, Van den Berg M, Ponfoort ED, Riemens F, van Unen J, Wobbes T, Wensing M, Laurant MG. Physician assistants in medical ward care: a descriptive study of the situation in the Netherlands. J Eval Clin Pract. 2016 Jun;22(3):395-402. doi: 10.1111/jep.12499. Epub 2015 Dec 23.
Timmermans MJ, van Vught AJ, Wensing M, Laurant MG. The effectiveness of substitution of hospital ward care from medical doctors to physician assistants: a study protocol. BMC Health Serv Res. 2014 Jan 28;14:43. doi: 10.1186/1472-6963-14-43.
Other Identifiers
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80-82310-97-12094
Identifier Type: -
Identifier Source: org_study_id
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