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PP159 Is Community Paramedicine A Safe/Effective Alternative To Usual Care?

International journal of technology assessment in health care, 2019, Vol.35 (S1), p.67-67 [Peer Reviewed Journal]

Copyright Cambridge University Press 2019 ;ISSN: 0266-4623 ;EISSN: 1471-6348 ;DOI: 10.1017/S0266462319002629

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  • Title:
    PP159 Is Community Paramedicine A Safe/Effective Alternative To Usual Care?
  • Author: Guo, Bing ; Corabian, Paula ; Yan, Charles
  • Subjects: Acuity ; Aging ; Chronic illnesses ; Clusters ; Emergency management ; Emergency medical care ; Emergency medical services ; Emergency response ; Emergency vehicles ; Evaluation ; Health care ; Identification methods ; Medical personnel ; Observational studies ; Patients ; Physicians ; Safety ; Technology assessment ; Training ; Transportation services
  • Is Part Of: International journal of technology assessment in health care, 2019, Vol.35 (S1), p.67-67
  • Description: Introduction Due to an aging population, shortage of healthcare staff, and escalating healthcare costs, there has been a recent shift in the professional roles and responsibilities in acute care settings to help bridge the care gap. Paramedics, whose primary responsibilities have been in emergency/transportation services, are increasingly involved in the management of chronic diseases in the community setting. However, even with additional training, there are concerns about the safety and effectiveness of this expanded role. The objective of this presentation is to highlight some of the key findings from a health technology assessment report on the safety and effectiveness of community paramedicine in assessing and managing conditions/diseases with low acuity. Methods A systematic review was conducted to identify studies that evaluated the safety and effectiveness of different community paramedicine programs. Results Four systematic reviews and 20 primary studies (one randomized controlled trial (RCT) and 19 observational studies) were identified. Of these, two systematic reviews and 14 primary studies focused on the safety and effectiveness of Emergency Care Practitioner (ECP) programs ΜΆ widely implemented programs whereby a paramedic or nurse undertakes activities traditionally performed by physicians, such as the initial assessment of patients, provision of simple treatment, or referral of patients to other clinical care. Limited evidence showed that ECP programs are promising in reducing repeated emergency calls, emergency department visits, hospital admissions/readmissions, and emergency transport charges. While the majority of included studies did not report any safety outcomes, no significant safety issues were identified from the cluster RCT. Evidence for other types of community paramedicine is limited. Conclusions Evaluation of the impact of community paramedicine programs remains methodologically challenging. Additional cluster RCTs may help determine the effectiveness of community paramedicine programs; safety outcomes should be a key element of future observational studies.
  • Publisher: Cambridge: Cambridge University Press
  • Language: English
  • Identifier: ISSN: 0266-4623
    EISSN: 1471-6348
    DOI: 10.1017/S0266462319002629
  • Source: ProQuest Central
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