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Observational Study
. 2023 Jul 10;24(4):786-792.
doi: 10.5811/westjem.57862.

Community Paramedicine Intervention Reduces Hospital Readmission and Emergency Department Utilization for Patients with Cardiopulmonary Conditions

Aaron Burnett  1 , Sandi Wewerka  2 , Paula Miller  2 , Ann Majerus  1   3 , John Clark  1 , Landon Crippes  2 , Tia Radant  1
Affiliations
Observational Study

Community Paramedicine Intervention Reduces Hospital Readmission and Emergency Department Utilization for Patients with Cardiopulmonary Conditions

Aaron Burnett et al. West J Emerg Med. .

Abstract

Objective: Patients discharged from the hospital with diagnoses of myocardial infarction, congestive heart failure or acute exacerbation of chronic obstructive pulmonary disease (COPD) have high rates of readmission. We sought to quantify the impact of a community paramedicine (CP) intervention on hospital readmission and emergency department (ED) and clinic utilization for patients discharged with these conditions and to calculate the difference in healthcare costs.

Methods: This was a prospective, observational cohort study with a matched historical control. The groups were matched for qualifying diagnosis, age, gender, and ZIP code. The intervention group received 1-2 home visits per week by a community paramedic for 30 days. We calculated the number of all-cause hospital readmissions and ED and clinic visits, and used descriptive statistics to compare cohorts.

Results: Included in the study were 78 intervention patients and 78 controls. Compared to controls, fewer subjects in the CP cohort had experienced a readmission at 120 days (34.6% vs 64.1%, P < 0.001) and 210 days (43.6% vs 75.6%, P < 0.001) after discharge. At 210 days the CP cohort had 40.9% fewer total hospital admissions, saving 218 bed days and $410,428 in healthcare costs. The CP cohort had 40.7% fewer total ED visits.

Conclusion: Patients who received a post-hospital community paramedic intervention had fewer hospital readmissions and ED visits, which resulted in saving 218 bed days and decreasing healthcare costs by $410,428. Incorporation of a home CP intervention of 30 days in this patient population has the potential to benefit payors, hospitals, and patients.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure 1
Figure 1
Standardized elements of community paramedic visits. AMI, acute myocardial infarction; COPD, chronic obstructive pulmonary disease; CHF, congestive heart failure.
Figure 2
Figure 2
Program timeline. CP, community paramedicine.
See this image and copyright information in PMC

References

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