eng Science and Education Publishing American Journal of Medical Sciences and Medicine 2327-6657 2025-08-07 13 3 29 33 10.12691/ajmsm-13-3-1 AJMSM20251331 article Virginia C. Hughes vhughes@udel.edu 1 Department of Medical and Molecular Sciences, University of Delaware, Newark, USA The PA Licensure Compact (PALC) is an optional agreement between states that aims to increase healthcare services for patients by allowing PA¡¯s with a license in a compact member state to practice in any other member state. Currently nineteen states have enacted the PALC. A study was conducted assessing factors that impact a states decision to join the PALC. State population density, number of PA programs, number of medical schools, rural population, rural land area, rural population density, number of PA¡¯s in each state, percentage of PA¡¯s in each state, PA¡¯s that participate in telemedicine, and number of physicians in each state with stratification into neonatal, cardiovascular, critical care, endocrinology, oncology, gastroenterology, and emergency medicine were analyzed in a logistic regression design. The number of PA Programs and PA¡¯s in each state, number of physicians practicing in the US, and specialties cardiovascular, gastroenterology, and emergency medicine were found to be statistically significant (P<.05). This study adds to the body of knowledge regarding the PALC and future outcomes as more states pass legislation to join the compact expanding access to healthcare. https://pubs.sciepub.com/ajmsm/13/3/1/ajmsm-13-3-1.pdf logistic regression telemedicine physician assistant