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Trends in ED hospital admissions and wait times by provider type after APP growth: A review of NHAMCS data from 2004 to 2021. APP增长后急诊住院率和按供应商类型划分的等待时间趋势：2004年至2021年NHAMCS数据回顾
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-09-01 Epub Date: 2026-08-25 DOI: 10.1097/01.JAA.0000000000000406
Tyler Roshak, Michael R Jiroutek, Melissa A Holland, Susan Avila Misciagno
{"title":"Trends in ED hospital admissions and wait times by provider type after APP growth: A review of NHAMCS data from 2004 to 2021.","authors":"Tyler Roshak, Michael R Jiroutek, Melissa A Holland, Susan Avila Misciagno","doi":"10.1097/01.JAA.0000000000000406","DOIUrl":"https://doi.org/10.1097/01.JAA.0000000000000406","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the annual proportion of emergency department (ED) visits resulting in hospital admission and to compare mean ED wait times before seeing a provider among patients cared for by a physician only, an advanced practice provider (APP) working with a physician, or an APP only from 2004 through 2021.</p><p><strong>Methods: </strong>A retrospective, cross-sectional analysis was conducted using data from the CDC's National Hospital Ambulatory Medical Care Survey-Emergency Department (NHAMCS-ED) from 2004 to 2021.</p><p><strong>Results: </strong>Hospital admission rates were comparable for visits managed by physicians only (12.7%; 95% CI, 11.9-13.4) and by APPs with physicians (12.8%; 95% CI, 11.8-13.8), whereas visits managed by APPs alone were associated with lower observed admission rates (2.4%; 95% CI, 1.9-2.9). Mean wait times were similar across provider types, averaging 43.8 minutes for physician-only visits, 44.6 for APP-physician visits, and 42.5 for APP-only visits.</p><p><strong>Conclusions: </strong>APPs practicing independently admitted patients at a lower rate than physicians alone and APPs with physicians, consistent with claims. Across the study period, all provider types saw a reduction in mean wait times, suggesting improved access to emergency care for patients.</p>","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 9","pages":"e10-e19"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lyme disease in a warming world: Rising cases, shifting patterns, and clinical implications. 莱姆病在变暖的世界：上升的病例，变化的模式，和临床意义。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-09-01 Epub Date: 2026-08-25 DOI: 10.1097/01.JAA.0000000000000409
Randi Shupp, Elyse Watkins
{"title":"Lyme disease in a warming world: Rising cases, shifting patterns, and clinical implications.","authors":"Randi Shupp, Elyse Watkins","doi":"10.1097/01.JAA.0000000000000409","DOIUrl":"https://doi.org/10.1097/01.JAA.0000000000000409","url":null,"abstract":"<p><strong>Abstract: </strong>Lyme disease, the most common vector-borne illness in the United States, is increasingly affecting regions beyond historically endemic areas. Warming temperatures and evolving ecosystems have contributed to the expansion of tick populations and altered seasonal activity, raising the likelihood of human exposure in areas previously considered low-risk. Clinicians must maintain a high index of suspicion for Lyme disease, even in patients without traditional geographic exposure. This article reviews the impact of environmental changes on the distribution and epidemiology of Lyme disease. It also provides an overview of clinical presentations, diagnostic strategies, and treatment recommendations. Emphasis is placed on early recognition, appropriate use of serologic testing, timely antibiotic therapy, and preventive measures to reduce disease burden. Awareness is crucial for delivering effective patient care and preventing complications in an evolving epidemiologic landscape.</p>","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 9","pages":"19-26"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CME POST-TESTS. 芝加哥商品交易所测试后。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-09-01 Epub Date: 2026-08-25 DOI: 10.1097/01.JAA.0000000000000414
{"title":"CME POST-TESTS.","authors":"","doi":"10.1097/01.JAA.0000000000000414","DOIUrl":"https://doi.org/10.1097/01.JAA.0000000000000414","url":null,"abstract":"","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 9","pages":"49"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In the Nigerian bush. 在尼日利亚的丛林里。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000383
Brian T Maurer
{"title":"In the Nigerian bush.","authors":"Brian T Maurer","doi":"10.1097/01.JAA.0000000000000383","DOIUrl":"https://doi.org/10.1097/01.JAA.0000000000000383","url":null,"abstract":"","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"50"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CME POST-TESTS. 芝加哥商品交易所测试后。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000394
{"title":"CME POST-TESTS.","authors":"","doi":"10.1097/01.JAA.0000000000000394","DOIUrl":"10.1097/01.JAA.0000000000000394","url":null,"abstract":"","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"49"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why PA demographics research is important. 为什么PA人口统计研究很重要。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000391
Richard W Dehn
{"title":"Why PA demographics research is important.","authors":"Richard W Dehn","doi":"10.1097/01.JAA.0000000000000391","DOIUrl":"10.1097/01.JAA.0000000000000391","url":null,"abstract":"","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"8-9"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nontraumatic acute compartment syndrome in all four extremities secondary to myxedema coma. 继发于黏液水肿昏迷的四肢非创伤性急性筋膜室综合征。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000384
Michael Boland, Brenton LaRiccia, Nicholas Bedrin
{"title":"Nontraumatic acute compartment syndrome in all four extremities secondary to myxedema coma.","authors":"Michael Boland, Brenton LaRiccia, Nicholas Bedrin","doi":"10.1097/01.JAA.0000000000000384","DOIUrl":"10.1097/01.JAA.0000000000000384","url":null,"abstract":"<p><strong>Abstract: </strong>Acute compartment syndrome (ACS) is a rare but potentially fatal sequela of myxedema coma. This article reports the second documented case of the presentation and management of a patient who developed ACS in all four extremities from severe hypothyroidism. This case represents an exceptional presentation of myxedema coma and highlights the potentially life-threatening complications from hypothyroidism and its improper treatment.</p>","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"31-32"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pregnancy considerations after metabolic and bariatric surgery. 代谢和减肥手术后怀孕的考虑。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000388
Rachel Pruitt
{"title":"Pregnancy considerations after metabolic and bariatric surgery.","authors":"Rachel Pruitt","doi":"10.1097/01.JAA.0000000000000388","DOIUrl":"10.1097/01.JAA.0000000000000388","url":null,"abstract":"<p><strong>Abstract: </strong>The prevalence of obesity-and the number of patients seeking treatment for this chronic, progressive disease-continues to rise. Bariatric surgery has long been an effective management option. The population of patients who undergo metabolic weight loss procedures consists predominantly of women and demonstrates a decreasing mean age, and as a result, more patients are undergoing surgery during their reproductive years and subsequently pursuing pregnancy. Although pregnancy following bariatric surgery is associated with improved outcomes compared with pregnancies complicated by uncontrolled obesity, it carries unique risks and potential complications, requiring more frequent and involved monitoring that may not be widely recognized among health care providers. This article reviews current guidelines for the management of patients after bariatric surgery, focusing in particular on those who conceive following these procedures.</p>","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"17-23"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Degenerative cervical myelopathy: Evolving concepts in diagnosis and treatment. 退行性脊髓型颈椎病：诊断和治疗概念的演变。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000385
Sarah Maddux, Yustina Lassen, Kenneth M Little
{"title":"Degenerative cervical myelopathy: Evolving concepts in diagnosis and treatment.","authors":"Sarah Maddux, Yustina Lassen, Kenneth M Little","doi":"10.1097/01.JAA.0000000000000385","DOIUrl":"10.1097/01.JAA.0000000000000385","url":null,"abstract":"<p><strong>Abstract: </strong>Degenerative cervical myelopathy (DCM) is a progressive, age-related condition caused by degenerative changes in the cervical spine that result in spinal cord compression and neurologic dysfunction. Though it is the leading cause of spinal cord impairment among adults, it is underrecognized in clinical practice due to its variable and often subtle presentation, resulting in delays in intervention and preventable morbidity and mortality. Timely diagnosis and intervention are critical, as shorter symptom duration is associated with superior outcomes. Heightened clinical vigilance and updated practice patterns are therefore essential among health care providers who are likely to encounter these patients in primary care, emergency medicine, urgent care, orthopedic, rheumatology, neurology, and neurosurgery settings. Emerging evidence favors early surgical intervention in progressive or moderate to severe disease among all patients, including older adults, to optimize outcomes and limit irreversible deficits.</p>","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"10-16"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aortic dissection. 主动脉夹层。
IF 0.9 4区 医学
Jaapa-Journal of the American Academy of Physician Assistants Pub Date : 2026-08-01 Epub Date: 2026-07-28 DOI: 10.1097/01.JAA.0000000000000390
John Weimer, M Allie Kraybill
{"title":"Aortic dissection.","authors":"John Weimer, M Allie Kraybill","doi":"10.1097/01.JAA.0000000000000390","DOIUrl":"10.1097/01.JAA.0000000000000390","url":null,"abstract":"","PeriodicalId":48728,"journal":{"name":"Jaapa-Journal of the American Academy of Physician Assistants","volume":"39 8","pages":"42-43"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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