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. 2024 Mar;38(1):169-176.
doi: 10.1111/scs.13220. Epub 2023 Oct 8.

Value-based care of older people-The impact of an acute outreach service unit on emergency medical service missions: A quasi-experimental study

Lauri J Mäki  1 , Perttu J Kontunen  1   2 , Johanna M Kaartinen  1 , Maaret K Castrén  1
Affiliations

Value-based care of older people-The impact of an acute outreach service unit on emergency medical service missions: A quasi-experimental study

Lauri J Mäki et al. Scand J Caring Sci. 2024 Mar.

Abstract

Background: Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit "Mobile hospital" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.

Methods: This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.

Results: Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.

Conclusions: LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.

Keywords: emergency medical services; health services for the aged; mobile health units; nursing homes.

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