TDNet Discover

Objective: To assess patient access to PAs and PA patient care quality per state practice categories. Methods: This retrospective observational study analyzed all 50 states and Washington D.C. using data from AAPA, NCCPA, and NPDB reports. States were categorized as reduced, moderate, or advanced/optimal by practice environments. Outcomes included PAs per 100,000 population, rates of PAs with Certificate of Added Qualifications (CAQs), board disciplinary actions, and malpractice payments. Statistical analyses with Kruskal-Wallis and Dunn’s were used to compare categories. Results: From 2019 to 2023, states with reduced or moderate practice declined by 28.6%, while advanced or optimal environments increased by 134.1%. Jurisdictions with advanced/optimal practice demonstrated significantly higher PAs per population (p < .001), indicating improved patient access to PAs per capita. CAQ rates differed across categories (p = .010), and no significant differences were found for board disciplinary actions (p = .718) or malpractice payments (p = .063). Conclusion: Advanced and optimal team practice environments were associated with greater patient access to PAs per capita without a reduction in care quality based on comparable disciplinary actions and malpractice claims across practice environments. These findings support continued modernization efforts of PA scope of practice laws to enhance access and efficiency in health care delivery. Future studies should assess patient-centered outcomes and state-level barriers influencing PA accessibility.