Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review

Elden, Odd Eirik; Uleberg, Oddvar; Lysne, Marianne; Haugdahl, Hege Selnes

doi:10.1136/bmjopen-2021-057752

Cited by 5 publications

(1 citation statement)

References 25 publications

(61 reference statements)

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“…This approach provides the solid foundation needed for decision-makers to commit to continuous funding. 50 While traditional medical research primarily focuses on biopsychosocial outcomes, it is crucial for future healthcare studies of community paramedicine programmes to address aspects such as treatment costs and economic evaluations.…”

Section: Discussionmentioning

confidence: 99%

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

Shannon,

Batt,

Eaton

et al. 2023

Paramedicine

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Objective This study aims to investigate the experiences of individuals involved in implementing and delivering community paramedicine programmes across several different regions internationally, in order to identify key themes that can inform ongoing development and introduction of community paramedicine programmes. Methods In this study, participants were enlisted through convenience sampling and a snowballing method. They responded to a custom survey emphasising open-ended responses. We employed a qualitative reflexive thematic analysis, utilising an inductive coding technique at the semantic/explicit level. This approach allowed us to discern themes from the participants’ accounts of the programme's implementation and delivery, along with their perceptions of its strengths and challenges. Results Data was collected from 29 participants engaged in the development or delivery of community paramedicine programmes spanning seven countries. Five themes were created: (1) community drives the need, which emphasises the importance of community engagement and flexible response to health needs; (2) working with others, which underscores the necessity of collaboration with stakeholders for integration and relationship maintenance; (3) promotion and communication, focusing on clarifying roles and countering misconceptions; (4) recruitment and support of community paramedics, highlighting the significance of experienced paramedic recruitment and providing support for staff retention; and (5) research and evaluation, stressing the importance of data sharing for patient care and programme evaluation. These themes demonstrate the significance of community-centred approaches, interprofessional practice, and programme evaluation in community paramedicine. Conclusion This study highlights the significance of community-centred approaches, interprofessional practice, and programme evaluation in community paramedicine. These findings can inform policymakers and practitioners in the development and implementation of community paramedicine programmes, ultimately improving the health and well-being of communities across different regions internationally.

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Section: Discussionmentioning

confidence: 99%

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

Shannon,

Batt,

Eaton

et al. 2023

Paramedicine

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The Economic Impact of Community Paramedics Within Emergency Medical Services: A Systematic Review

Wilkinson-Stokes,

Tew,

Yap

et al. 2024

Appl Health Econ Health Policy

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Background and Objective Globally, emergency medical services (EMSs) report that their demand is dominated by non-emergency (such as urgent and primary care) requests. Appropriately managing these is a major challenge for EMSs, with one mechanism employed being specialist community paramedics. This review guides policy by evaluating the economic impact of specialist community paramedic models from a healthcare system perspective. Methods A multidisciplinary team (health economics, emergency care, paramedicine, nursing) was formed, and a protocol registered on PROSPERO (CRD42023397840) and published open access. Eligible studies included experimental and analytical observational study designs of economic evaluation outcomes of patients requesting EMSs via an emergency telephone line (‘000’, ‘111’, ‘999’, ‘911’ or equivalent) responded to by specialist community paramedics, compared to patients attended by usual care (i.e. standard paramedics). A three-stage systematic search was performed, including Peer Review of Electronic Search Strategies (PRESS) and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Two independent reviewers extracted and verified 51 unique characteristics from 11 studies, costs were inflated and converted, and outcomes were synthesised with comparisons by model, population, education and reliability of findings. Results Eleven studies ( n = 7136 intervention group) met the criteria. These included one cost-utility analysis (measuring both costs and consequences), four costing studies (measuring cost only) and six cohort studies (measuring consequences only). Quality was measured using Joanna Briggs Institute tools, and was moderate for ten studies, and low for one. Models included autonomous paramedics (six studies, n = 4132 intervention), physician oversight (three studies, n = 932 intervention) and/or special populations (five studies, n = 3004 intervention). Twenty-one outcomes were reported. Models unanimously reduced emergency department (ED) transportation by 14–78% (higher quality studies reduced emergency department transportation by 50–54%, n = 2639 intervention, p < 0.001), and costs were reduced by AU$338–1227 per attendance in four studies ( n = 2962). One study performed an economic evaluation ( n = 1549), finding both that the costs were reduced by AU$454 per attendance (although not statistically significant), and consequently that the intervention dominated with a > 95% chance of the model being cost effective at the UK incremental cost-effectiveness ratio threshold. Conclusions Community paramedic roles within EMSs reduced ED transportation by approximately half. However, the rate was highly variable owing to structural (such as local...

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Implementing community paramedicine: A known player in a new role. A narrative review

Spelten

Thomas

Vuuren

et al. 2024

Australasian Emergency Care

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Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review

Cited by 5 publications

References 25 publications

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

The advantages and challenges experienced with the implementation and delivery of community paramedicine programmes: A qualitative reflexive thematic analysis

The Economic Impact of Community Paramedics Within Emergency Medical Services: A Systematic Review

Implementing community paramedicine: A known player in a new role. A narrative review

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