BOSTON – The presence of a certified orthopedic-trained physician assistant reduced length of stay, cut costs and improved discharge disposition among patients who underwent total knee arthroplasty in a large hospital system, according to researchers.

“Timely communication is enhanced and participation in hospital quality improvement committees has lead to more rapid development and implementation of patient care and quality initiatives,” Brett Osgood, MS, PA-C, of Summit Orthopedics of Summit, N.J., and colleagues reported at the American Academy of Physician Assistants IMPACT 2014 meeting.

They examined discharge data and economic data from three large hospitals in a single large hospital system before and after implementation of a single full-time orthopedic trained PA at each location from six months prior to the PAs’ start dates until six months after.

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Length of stay, discharge disposition and costs were assessed for 2,004 patients who underwent total knee arthroplasty.

The researchers observed statistically significant improvements on all measures six months after the PA was hired compared with six months before:

  • Proportion of patients discharged to home – 72% vs. 78%; P=0.006
  • Length of stay – 2.79 days vs. 3.02 days; P<0.001
  • Cost per patient admission – $11,487 vs. $11,811; P=0.029

Other key improvements included increased orthopedic staff availability, improved response times to patient needs, improved response time to nursing needs, enhanced communication and greater orthopedic group involvement in hospital quality improvement plans.

“The PA-C presence has been shown to increase the access of hospital staff to an orthopedic provider and to provide key perspective on patient care initiatives.”


  1. Osgood B et al. Poster #221. “Reduced Length of Stay, Reduced Cost and Improved Discharge Disposition After Implementation of a Hospital-Based Orthopedic Trained PA-C.” Presented at: AAPA 2014. Boston; May 23-28, 2014.