Average value per visit | Physician (reference) | Any NP/PA | P value | Physician (reference) | NP/PA Alone | P value | NP/PA-physician combination | P value |
Time per visit (min) | 288.74 (n=117 294) | 295.4 (n=26 092) | 0.17 | 267.6 (n=1 17 294) | 245.9 (n=9798) | 0.02 | 289.8 (n=16 294) | <0.001 |
Number of medications | 2.76 (n=143 687) | 2.91 (n=33 870) | 0.001 | 2.80 (n=1 43 687) | 2.62 (n=12 410) | 0.002 | 3.08 (n=21 460) | <0.001 |
Number of diagnostic tests | 5.07 (n=142 095) | 5.09 (n=33 479) | 0.78 | 4.66 (n=1 42 095) | 3.77 (n=12 237) | <0.001 | 5.07 (n=21 242) | <0.001 |
Number of procedures | 0.84 (n=139 788) | 0.87 (n=33 150) | 0.06 | 0.77 (n=1 39 788) | 0.67 (n=12 154) | <0.001 | 0.86 (n=20 996) | <0.001 |
Whether visit resulted in hospitalisation (ORs) | Ref (n=143 687) | 0.99 (95% CI 0.88 to 1.11) (n=33 870) | 0.84 | Ref (n=1 43 687) | 0.35 (95% CI 0.26 to 0.46) (n=12 410) | <0.001 | 1.33 (95% CI 1.17 to 1.51) (n=21 460) | <0.001 |
Note: some of the utilisation measures had missing data leading to differing sample sizes; however, for measures other than length of visit, these missing data comprised ~3% of the sample and were included in our analyses. Also note, utilisation during physician visits reflect the reference group for all comparisons: (1) any NP/PA visit versus physician alone, (2) NP/PA alone visit vs physician alone visit, (3) visits including the NP/PA–physician combination versus visits including physicians alone.
*These results include propensity score weighted and multivariable linear and logistic regression models, which account for age, sex, race, comorbidities, primary diagnosis categories, triage acuity, insurance status, patient residence (eg, whether the patient lives in a nursing home), whether the ED was located in an urban or rural setting, US region and year.
ED, emergency department; NPs/PAs, nurse practitioners and physician assistants; ref, reference group