地域医療と健康教育

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Development Costs of Inaugurating a Physician Assistant Program

Yealy J and Hooker RS

To understand the process of developing a new physician assistant program in the US a 10-year prospective study was undertaken. Critical pathway protocol included a daily log of activity. Expenditures, revenues, and budgets were adjusted to 2015 dollars. The study begins in year one with the Chancellor of the University advocating a program, followed by approvals from the Board of Trustees and Faculty Senate. Next the dean formed a search committee; department chair, program director, key faculty, and staff were hired. The first 10 years of operation was $10.5 M and the break-even point occurred in year 8 based on tuition revenue of $8.4 M. Remodeling classrooms, a laboratory, patient examination simulation spaces were significant expenses. Unanticipated events delayed implementation resulting in cost over runs but in retrospect many could have been avoided. In the end The University of Tennessee’s Physician Assistant program’s opportunity cost for a student was $1200 per month. In summary, the development of a PA program was more complex, lengthy, and costly than predicted by consultants. Critical pathway analysis identified many interconnecting nodes that interfered with the process but with improved modeling could avoid or mitigate them. Comparison of development cost of other types of PA programs is needed research.