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healthcare systems final


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replaces a service, independent of physicians
ability of PA to fx without direct supervision
enhances a service, when the performance is directed or determined by a physician
PA cost effectiveness
1pa:.83 physician, or about 83% of a physicians job
productivity values
PA can increase medical productivity from 49-74%, with a pt count increase of 150-274
how much can a PA increase office visits?
12-37% during first year
what size practice if optimal for PA to be involved with physiscans?
3 or fewer physicians
the % of primary care medical responsibilities that can be safely handled by a PA under optimum conditions
functionality of PA to residents
60% of medical directors prefer PA's over residents
PA's used fewer ancillary services for pneumonia, stroke, heart failur
the decision to request a physician's counsel on a specific medical scenario.
consultation rate
rate=#of consultations of any type per total visits in a given time period
do new PA's seek out more or less physician consultation?
MORE - they're new
a state legislated term that has both legal and economic implications
clinical productivity
measures changes in output that happen when small changes are incurred in one factor of production, with all other variables remaining constant
how is clinical productivity measured?
by number of pt visits
functional delegation
the assessment of PA functinoality by
1. the basis of tasks the PA is allowed to perform
2. the full range of tasks performed by a physician
what is the care generated per dollar of salary b/t NPP's and famly physicians?
NPP = $2.68
family physician $2.62
what three modes are PA costs evaluated?
1. fiscla benefit overriding cost of hiring
2. more desirable to hire PA or physician
3. societal concern of how to deliver high-quality care at a minimum cost
salary and benefits compared to revenue
what is the PA compensation value?
.38, compared to physician of .44, NP, .41
smaller the number, the more the value
value of delivered care in using education cost and timeframe as evaluatin
PA's will have delivered 405,000 hours worth of care by the time the physician, who started school the same year, is providing care
what is the substitution ratio of PA's:physicians in primary care?
what factors decrease effectiveness of the PA role?
1. prescritive authority -limitations
2. stipulations on what/how much can Rx
3.requiring a co-signature
approximately how many prescriptions do PA's write in a year?
17.8 million, cornering 6% of the total market
barriers to practice
1.eligibility for reimbursement
2. prescription favorability

(WA and MT are most favorable)
third party reimbursement- how much does Medicare part B cover for PA's in hospital setting?
85% of physician fees
100% if physician is on site, and sees all new pts
what is the educational time frame b/t NP's and PA's?
PA program 24-36months requires at least 2yrs college and some HC exp. for admin. most have earned a bachelor’s degree and have an average of 48 months of HC exp. before admin

o Nurse Practitioners are RNs with a BSN and a master’s degree who complete graduate-level academics, which equals about 2 years additional to the two to four year RN degree

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