The Rise of Advanced Practice Providers (APP) in Hospital Patient Care

This chapter explores the use of Advanced Practice Providers in hospital-based care, particularly in the critical care setting. Increasing number of physician assistants and advanced practice registered nurses (NP, CRNA, CNS, etc.) are providing care in hospital critical care service lines. When compared to more traditional physician-resident/fellow critical care units, physician-APP staffed units show comparable, and in some metrics improved outcomes. Results have been mixed on the cost-effectiveness of this physician-APP model when studied. There are concerns that increased use of APP in academic medical centers may affect the training of house staff. Government estimates anticipate continued growth of the APP in the hospital-based care workforce.