Conserving Quality of Life through Community Paramedics

Ashton, Christopher; Duffie, Denise; Millar, Jeffrey

doi:10.12927/hcq.2017.25228

Cited by 19 publications

(19 citation statements)

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“…Nurses' poor health status and HRQoL primarily showed the difficulties they face in their work. They work a highly stressful and demanding profession which is not very well rewarded, as reported in several studies [38][39][40][41]. The auxiliary personnel (although they were low in number in our study) seem to have the worst health status and poorer HRQoL compared to other studies [42][43][44].…”

Section: Discussioncontrasting

confidence: 52%

Psychological Distress and Health-Related Quality of Life in Public Sector Personnel

Malfa

Karaivazoglou

Assimakopoulos

et al. 2021

IJERPH

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Background: This study has assessed health-related quality of life (HRQoL) and psychological distress between public sector professional groups. Methods: Short Form-36 Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were administered to healthcare personnel, schoolteachers, and municipality and regional personnel in the region of Western Greece. Mean scores on all SF-36 dimensions and HADS were compared among these professional groups as well as with the Greek national norms to assess if there were significant differences between our study sample and the general population. Results: Healthcare personnel reported significantly lower SF-36 scores than teachers and municipality employees. Women reported poorer HRQoL than men on all SF-36 dimensions. This overall low score for health care workers masks the fact that male health care workers, primarily medical doctors, actually scored better than women, primarily nurses and auxiliary personnel. Average mean scores on all SF-36 dimensions reported by nurses and auxiliary personnel in healthcare were considerably lower than the ones from employees in all other occupational types. The impact on HRQoL observed mainly in vitality, social functioning and mental health was important. Many participants have shown psychological burden and depression. Conclusions: The health inequalities among healthcare employees are significant. This study is important to suggest taking measures for improving the HRQoL of health workers.

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Section: Discussioncontrasting

confidence: 52%

Psychological Distress and Health-Related Quality of Life in Public Sector Personnel

Malfa

Karaivazoglou

Assimakopoulos

et al. 2021

IJERPH

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“…This is followed by the EQ-5D-3 L [26], a validated questionnaire developed by the EuroQol Group that measures HRQoL and can be used to calculate quality-adjusted life years (QALYs) for economic evaluation [27]. The EQ-5D-3 L, which has been applied previously in a paramedic setting in Ontario [28], has two components: (1) a Likert-scale of 5 items (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with three response options (no problems to extreme problems); and, (2) and a visual analog scale of health status on the current day, presented as a thermometer from 0 (worst imaginable health state) to 100 (best imaginable health state). These questions were unaltered from the validated EQ-5D-3 L questionnaire [27].…”

Section: Resultsmentioning

confidence: 99%

Development of the Health Awareness and Behaviour Tool (HABiT): reliability and suitability for a Canadian older adult population

Agarwal

Pirrie

Angeles

et al. 2019

J Health Popul Nutr

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BackgroundDetermining the effectiveness of community-based health promotion and disease prevention programs requires an appropriate data collection tool. This study aimed to develop a comprehensive health questionnaire for older adults, called the HABiT, and evaluate its reliability, content validity, and face validity in assessing individual health-related items (e.g., health status, healthcare utilization) and five specific scales: knowledge, current health behaviors (risk factors), health-related quality of life (HRQoL), perceived risk and understanding, and self-efficacy.MethodsIterative survey development and evaluation of its psychometric properties in a convenience sample of 28 older adults (≥ 55 years old), half from a low-income population. Following item generation, the questionnaire was assessed for content validity (expert panel), face validity (participant feedback), internal consistency of each scale (Cronbach’s alpha), and test-retest reliability for each item and scale (Pearson’s r and phi correlations, as appropriate).ResultsQuestions were drawn from 15 sources, but primarily three surveys: Canadian Community Health Survey, Canadian Diabetes Risk Questionnaire (CANRISK), and a survey by the Canadian Hypertension Education Program. Expert consensus was attained for item inclusion and representation of the desired constructs. Participants completing the questionnaire deemed the questions to be clear and appropriate. Test-retest reliability for many individual items was moderate-to-high, with some exceptions for items that can reasonably change in a short period (e.g., perceived day-to-day stress). Of the five potential scales evaluated, two had acceptable internal consistency (Cronbach’s alpha ≥ 0.60) and a subset of one scale also had acceptable internal consistency. Test-retest reliability was high (correlation ≥ 0.80) for all scales and sub-scales.ConclusionsThe HABiT is a reliable and suitable comprehensive tool with content and face validity that can be used to evaluate health promotion and chronic disease prevention programs in older adults, including low-income older adults. Some noted limitations are discussed. Data collected using this tool also provides a diabetes risk score, health literacy score, and quality-adjusted life years (QALYs) for economic analysis.

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“…The incremental cost per QALY for CP@clinic is very reasonable compared with existing Canadian literature on CP interventions. The ICER of a home visit programme in Renfrew County, Ontario has been described to be between $67 000 and $76 000 8 compared with the CP@clinic ICER of $2933. The commonly held threshold for willingness to pay for an intervention is $C50 000.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study conducted in Renfrew County, Ontario, performed an economic evaluation of a home visit programme model (ageing at home) and was able to demonstrate an incremental cost per quality-adjusted life year (QALY). 8 However, no studies have evaluated the cost-effectiveness of a wellness or clinic style community model of CP.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of a community paramedicine programme for low-income seniors living in subsidised housing: the community paramedicine at clinic programme (CP@clinic)

et al. 2020

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ObjectivesTo evaluate the cost-effectiveness of the Community Paramedicine at Clinic (CP@clinic) programme compared with usual care in seniors residing in subsidised housing.DesignA cost–utility analysis was conducted within a large pragmatic cluster randomised controlled trial (RCT). Subsidised housing buildings were matched by sociodemographics and location (rural/urban), and allocated to intervention (CP@clinic for 1 year) or control (usual care) via computer-assisted paired randomisation.SettingThirty-two subsidised seniors’ housing buildings in Ontario.ParticipantsBuilding residents 55 years and older.InterventionCP@clinic is a weekly community paramedic-led, chronic disease prevention and health promotion programme in the building common areas. CP@clinic is free to residents and includes risk assessments, referrals to resources, and reports back to family physicians.Outcome measuresQuality-adjusted life years (QALYs) gained, measured with EQ-5D-3L. QALYs were estimated using area-under-the curve over the 1-year intervention, controlling for preintervention utility scores and building pairings. Programme cost data were collected before and during implementation. Costs associated with emergency medical services (EMS) use were estimated. An incremental cost effectiveness ratio (ICER) based on incremental costs and health outcomes between groups was calculated. Probabilistic sensitivity analysis using bootstrapping was performed.ResultsThe RCT included 1461 residents; 146 and 125 seniors completed the EQ-5D-3L in intervention and control buildings, respectively. There was a significant adjusted mean QALY gain of 0.03 (95% CI 0.01 to 0.05) for the intervention group. Total programme cost for implementing in five communities was $C128 462 and the reduction in EMS calls avoided an estimated $C256 583. The ICER was $C2933/QALY (bootstrapped mean ICER with Fieller’s 95% CI was $4850 ($2246 to $12 396)) but could be even more cost effective after accounting for the EMS call reduction.ConclusionThe CP@clinic ICER was well below the commonly used Canadian cost–utility threshold of $C50 000. CP@clinic scale-up across subsidised housing is feasible and could result in better health-related quality-of-life and reduced EMS use in low-income seniors.Trial registration numberClinicaltrials.gov, NCT02152891.

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Conserving Quality of Life through Community Paramedics

Cited by 19 publications

References 0 publications

Psychological Distress and Health-Related Quality of Life in Public Sector Personnel

Psychological Distress and Health-Related Quality of Life in Public Sector Personnel

Development of the Health Awareness and Behaviour Tool (HABiT): reliability and suitability for a Canadian older adult population

Cost-effectiveness analysis of a community paramedicine programme for low-income seniors living in subsidised housing: the community paramedicine at clinic programme (CP@clinic)

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