Utilizing Nurse Practitioners and Physician Assistants in Academic Emergency Departments Does Not Reduce Residents' Exposure to More Complex Patients
Authors: Meghal Mehta, Sara Scott, Lawrence H Brown
Published in: Journal of Emergency Medicine, 2023 November 19
Conclusions:
- Higher utilization of NPs and PAs in academic EDs does not diminish EM residents' exposure to complex patients or their involvement in ACGME-required procedures.
Methods:
- A cross-sectional analysis using National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2016 to 2020.
- Nonpediatric academic EDs were categorized based on the percentage of patients seen by NPs or PAs: lower (≤10%), moderate (10.1%-30%), and higher (>30%) utilization groups.
- The study evaluated the proportion of patients seen by EM residents that met predefined criteria for complexity and those undergoing specific ACGME-required procedures.
Results:
- The analysis represented 44,130,996 adult patient visits to nonpediatric academic EDs seen by residents.
- There was no significant difference in the proportion of resident-seen patients meeting complex patient criteria across NP/PA utilization levels: lower (43.2%), moderate (41.7%), and higher (38.9%) utilization groups.
- Similarly, the performance of ACGME-required procedures by residents did not significantly vary with the level of NP/PA utilization.