Value‐based care of older people—The impact of an acute outreach service unit on emergency medical service missions: A quasi‐experimental study

Abstract

AbstractBackgroundTransfers to the emergency department can be burdensome for the residents of long‐term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse‐led acute outreach service unit “Mobile hospital” (in Finnish, Liikkuva sairaala, LiiSa) has been providing on‐site care to LTRCF residents to reduce transfers to the emergency department.MethodsThis study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six‐month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A–D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.ResultsDue to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%–22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%–30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%–41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.ConclusionsLiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.