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. 2022 May-Jun;26(3):410-421.
doi: 10.1080/10903127.2021.1922556. Epub 2021 May 27.

Assessment of Fall-Related Emergency Medical Service Calls and Transports after a Community-Level Fall-Prevention Initiative

Catherine C Quatman-Yates  1 , David Wisner  1 , Mark Weade  1 , Mindy Gabriel  1 , Jessica M Wiseman  1 , Elizabeth Sheridan  1 , Jennifer H Garvin  1 , John F P Bridges  1 , Heena P Santry  1 , Ashish R Panchal  1 , Soledad Fernandez  1 , Carmen E Quatman  1
Affiliations

Assessment of Fall-Related Emergency Medical Service Calls and Transports after a Community-Level Fall-Prevention Initiative

Catherine C Quatman-Yates et al. Prehosp Emerg Care. 2022 May-Jun.

Abstract

Background: Getting effective fall prevention into the homes of medically and physically vulnerable individuals is a critical public health challenge. Community paramedicine is emerging globally as a new model of care that allows emergency medical service units to evaluate and treat patients in non-emergency contexts for prevention efforts and chronic care management. The promise of community paramedicine as a delivery system for fall prevention that scales to community-level improvements in outcomes is compelling but untested.Objective: To study the impact of a community paramedic program's optimization of a fall prevention system entailing a clinical pathway and learning health system (called Community-FIT) on community-level fall-related emergency medical service utilization rates.Methods: We used an implementation science framework and quality improvement methods to design and optimize a fall prevention model of care that can be embedded within community paramedic operations. The model was implemented and optimized in an emergency medical service agency servicing a Midwestern city in the United States (∼35,000 residents). Primary outcome measures included relative risk reduction in the number of community-level fall-related 9-1-1 calls and fall-related hospital transports. Interrupted time series analysis was used to evaluate relative risk reduction from a 12-month baseline period (September 2016 - August 2017) to a 12-month post-implementation period (September 2018-August 2019).Results: Community paramedic home visits increased from 25 in 2017, to 236 in 2018, to 517 in 2019, indicating a large increase in the number of households that benefited from the efforts. A relative risk reduction of 0.66 (95% [CI] 0.53, 0.76) in the number of fall calls and 0.63 (95% [CI] 0.46, 0.75) in the number of fall-related calls resulting in transports to the hospital were observed.Conclusions: Community-FIT may offer a powerful mechanism for community paramedics to reduce fall-related 9-1-1 calls and transports to hospitals that can be implemented in emergency medical agencies across the country.

Keywords: community paramedicine; fall prevention; injury prevention; older adult falls.

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Conflict of interest statement

Declaration of Interest Statement

The authors have no relevant financial or non-financial competing interests to report for this project.

Figures

Figure 1.
Figure 1.
Clinical Pathway for Community-FIT.
Figure 2.
Figure 2.
Population-Adjusted Outcomes by Phase.
See this image and copyright information in PMC

References

    1. Nkanang B, Parker M, Parker E, Griffiths R. Perioperative mortality for patients with a hip fracture. Injury. 2017;48(10):2180–3. - PubMed
    1. Ray R, Clement ND, Aitken SA, McQueen MM, Court-Brown CM, Ralston SH. High mortality in younger patients with major osteoporotic fractures. Osteoporo Int. 2017;28(3):1047–52. doi: 10.1007/s00198-016-3827-9. - DOI - PubMed
    1. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc. 2018;66(4):693–8. - PMC - PubMed
    1. CDC. Older Adult Falls 2018. [updated February 10, 2017 March 16, 2018]. Available from: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html.
    1. Ho P, Bulsara M, Downs J, Patman S, Bulsara C, Hill A-M. Incidence and prevalence of falls in adults with intellectual disability living in the community: a systematic review. JBI Database System Rev Implement Rep. 2019;17(3):390–413. - PubMed

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