Abstract
BackgroundCommunity paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development.MethodsA series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively. Each CP programme uses its own model with unique goals, as well as providing corresponding services/care based on the demands from their communities.ResultsThree CP programmes in the study were mainly aimed at reducing healthcare resource utilisation (ie, reduce readmissions or ED utilisation), but one of the programmes developed a sustainable model aiding newborn care in the community. Establishing a solid reimbursement mechanism and working closely with collaborators are two major strategies for developing sustainable CP programmes. Complete data collection and a programme evaluation process will also be important to demonstrate the value of its CP models to potential collaborators and policy-makers. However, the cost-effectiveness of a CP model is still not easy to identify due to the separate programmes being developed without uniform goals.ConclusionThe challenges and solutions from the four programmes under study can provide a road map for the development of CP programmes for other communities.
Funder
National Science Foundation
Subject
Critical Care and Intensive Care Medicine,General Medicine,Emergency Medicine
Reference23 articles.
1. Zavadsky M . How MedStar’s Mobile Integrated Healthcare Program Restored Patient’s Hope. 2014 http://www.jems.com/articles/print/volume-39/issue-7/features/how-medstar-s-mobile-integrated-healthca.html?c=1 (accessed 15 Jul 2017).
2. Pennslyvania Emergency Health Services Council. Community paramedicine: a new approach to integrated healthcare. Pennslyvania: Pennslyvania Emergency Health Services Council, 2014.
3. Coffman J , Wides C , Niedzwiecki M , et al . Evaluation of California’s community paramedicine pilot project. 2017 http://pehsc.org/wp-content/uploads/2014/05/PEHSC-CP-Whitepaper_Production-Copy.pdf (accessed 15 Jul 2017).
4. Effectiveness of emergency care practitioners working within existing emergency service models of care
5. Effectiveness of paramedic practitioners in attending 999 calls from elderly people in the community: cluster randomised controlled trial
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