A study of physicians' assistants in a rural setting

Area of Science:

• Health Services Research
• Rural Health
• Medical Workforce Studies

Background:

• Rural areas face unique healthcare challenges, including access and cost.
• Physicians' assistants (MEDEX) were introduced to potentially improve healthcare delivery in Southern Appalachia.
• General practitioners' offices were the setting for this three-year study.

Purpose of the Study:

• To evaluate the impact of employing physicians' assistants (MEDEX) in rural primary care settings.
• To assess changes in healthcare utilization, care type, and hospitalization rates.
• To determine the role and effectiveness of MEDEX in improving rural healthcare.

Main Methods:

• A before-after and experimental-control (county) study design was employed.
• Data were collected from physician office contracts and population surveys.
• The study spanned a three-year period in a rural Southern Appalachian county.

Main Results:

• Average weekly office visits increased significantly.
• The balance between preventive and curative care remained stable.
• Hospitalization rates showed a continuous increase among physicians utilizing MEDEX.
• MEDEX primarily functioned as physician substitutes rather than assistants.

Conclusions:

• Employing physicians' assistants can enhance healthcare utilization in rural settings.
• MEDEX did not demonstrably reduce long-term medical care costs.
• The introduction of MEDEX did not lead to an increase in preventive or ambulatory care.
• Further research is needed to optimize the role of MEDEX in rural healthcare systems.