Understanding the geographic distribution of physician assistants (PAs) can inform health care workforce planning. This study examines PA supply by state and county. Also examined is the relationship between PA supply and level of urbanization as well as state laws governing PA practice.
The addresses of all NCCPA-certified PAs were identified from the AAPA Masterfile and used to estimate PA to population ratios. PA supply in rural and urban communities was analyzed by linking records from the AAPA Masterfile to the 2007 Federal Area Resource File using county identifiers. PA supply was also examined according to the favorability of state laws towards PA practice.
State PA supply varies from 0.6 PAs per 10,000 population in Mississippi to 5.6 PAs per 10,000 population in Alaska. Counties with PAs were more likely to be urbanized, whereas those without PAs were more likely to be rural. States identified as “unfavorable” for PA practice were found to have notably lower PA supply compared to other states.
Substantial variation exists in the PA-to-population ratio among states, which may be related in part to state practice laws. At a more local level, counties without PAs are more likely to be rural than counties with PAs. The distribution of PAs is likely to remain geographically uneven in the absence of significant policy efforts to attract PAs to practice in rural communities.