Physician assistants (PAs) are to be integrated into GP practices in the project. The aim is to investigate how interprofessional practice teams can work together effectively and trustfully in future collaborations in order to master the challenges of the future.
Conditions
Interventions
Group 1: The intervention practices employ a physician assistant in their practice for a period of 18 months.
Group 2: Practices that were randomized to the control group continue to work without empl
Sponsors
Institut für Allgemeinmedizin, Universitätsmedizin Essen, Medizinische Fakultät, Universität Duisburg-Essen
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Criteria for GP practices to participate as a study cluster PA: Completed Physician Assistant studies with a Bachelor's degree by the time of recruitment (no later than 31.12.2025). Willingness to work full-time or part-time with at least 50% job scope. General practitioner practices: in a region with a coverage rate < 100% according to the information provided by the participating Kassenärztliche Vereinigungen Westfalen-Lippe and Schleswig-Holstein. If not enough GPs are reached with this restriction, GPs in a region with a coverage rate = 100% can also be included in a second step. Criteria for interviewing practice staff as part of the primary data collection All physicians and medical assistants of the included control and intervention practices who have consented to participate in the surveys. Criteria for interviewing patients as part of the primary data collection All patients of the included control and intervention practices. Inclusion criteria for the secondary data analysis by the Zi All patients who were treated at least once in one of the participating practices during the observation period. Inclusion criteria for the secondary data analysis of BARMER patients All patients insured with BARMER who were treated at least once in one of the participating practices during the observation period. Inclusion criteria for the secondary data analysis of AOK patients (via WIdO) All patients insured with an AOK who were treated at least once in one of the participating practices during the observation period.
Exclusion criteria
Exclusion criteria: Criteria for GP practices to be excluded as a study cluster PAs: who already work in a GP practice and wish to remain in their employment. GP practices: in which a PA or an MFA who is studying to become a PA is employed. Criteria for the exclusion of practice staff as part of the primary data collection none Criteria for the exclusion of patients as part of the primary data collection Minors or patients who are acutely or chronically incapable of giving consent Exclusion criteria for secondary data analysis by the Zi none Inclusion criteria for the secondary data analysis of BARMER patients none Inclusion criteria for the secondary data analysis of AOK patients (via WIdO) none
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary endpoint is a combined endpoint defined as the number (frequency) of occurrences of the following endpoints per patient: - Frequency of use of the on-call medical service - Frequency of emergency department use - Frequency of outpatient-sensitive hospitalizations - death | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of cases Treatment volume/daily cases Utilization of specialists Home visit activities Vaccination rate Preventive check-ups Spinal imaging DMP diabetes (kidney values, eye check.) LL-appropriate pharmacotherapy Polypharmacy: PPI, antibiotics, psychotropic drugs, potentially inadequate medications (PIMs) Medium number. Digital innovation push Utilization Costs Appointment waiting time Average waiting time (in minutes) Rate of rejection of new patients Treatment of acute patients per doctor present Patient treatment satisfaction | — |
Countries
Germany
Contacts
Public ContactAlessia Dehnen
Institut für Allgemeinmedizin, Universitätsmedizin Essen, Medizinische Fakultät, Universität Duisburg-Essen
Outcome results
None listed