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首页> 外文期刊>Journal of Health Services Research & Policy >Physician assistants: does the US experience have anything to offer other countries?
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Physician assistants: does the US experience have anything to offer other countries?

机译：医师助理：美国的经验对其他国家有帮助吗？

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The development of physician assistants (PAs) is rootednin 18th century Germany and Russia (feldshers) and 19thncentury France (of.cier de sante´). More recent examplesnof PAs include the clinical of. cer in Africa and thenmedical assistants/medical of. cers in Asia and Oceania,nwhere they are pivotal in extending needed health carenservices to rural and remote areas.1 But what is knownnabout the contribution PAs make in industrializedncountries, and particularly in the USA, today?nThe US experiencenIn the USA, PAs were developed in the 1960s to expandncapacity in primary care where doctors were oftennoverworked in rural and medically under-served areas.nThe PA has been viewed as a success, with over 45 000nnow in clinical practice. Approximately half work innprimary care and the others in specialty practices.nAlmost a quarter are located in rural and frontierncounties, usually in communities of fewer than 10 000,nand 10% are in towns of less than 5000 population.nAnother 12% work in inner cities.2nThe general medical education of PAs gives them thenability to move between various clinical settings andnspecialties: primary care, trauma units, hospitals. In allnsettings they share in diagnosing and treating commonnmedical problems and providing wellness checks.nOutside primary care the PAs appear to be effective innall of the surgical specialties and the majority of thenmedical specialties.3nStudies of PA cost-effectiveness consistently revealnadvantages.4 Demand for PA services presently exceedsnsupply, with opportunities for employment fairly strongnin nearly all parts of the country.5 The US government,nincluding the military, employs over 12% of PAs; statengovernments and large health maintenance organizationsnare other major employers.2
机译：医师助理（PAs）的发展起源于18世纪的德国和俄罗斯（feldshers）以及19世纪的法国（of.cier de sante´）。 PAs的最新例子包括临床。非洲的cer，然后是医疗助理/医疗人员。在亚洲和大洋洲，它们在将所需的健康护理服务扩展到农村和偏远地区方面起着关键作用。1但是，如今人们对PA在工业化国家（尤其是在美国）中的贡献知之甚少？n美国的经验在美国已经开发了PA在1960年代，PA扩大了基层医​​疗服务的能力，在农村和医疗服务不足的地区，医生经常没有工作。nPA被认为是成功的，在临床实践中已有超过45000的知识。大约一半的人在初级保健部门工作，而其他人则在专科诊所工作。n将近四分之一位于农村和边远县，通常在少于1万的社区中，而10％在人口少于5000的城镇。n另外12％在内城区工作.2n对PA的一般医学教育使他们能够在各种临床环境和专业之间移动：初级保健，创伤病房，医院。在所有环境中，他们共同诊断和治疗常见的医学问题并提供健康检查。n在初级护理之外，PA似乎在外科手术专科和大多数随后的医学专科中都不起作用。3n对PA成本效益的研究始终显示出弊端。4对PA服务的需求目前，美国的供过于求情况几乎遍及全国几乎所有国家。5美国政府（包括军方）雇用了超过12％的巴勒斯坦权力机构；州政府和大型健康维护组织没有其他主要雇主。2

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