Community preventive care clinics help reduce 911 calls and boost health: study
Published Monday, May 28, 2018 10:00PM EDT
Last Updated Monday, May 28, 2018 10:27PM EDT
Paramedics can do a lot more than just save lives during emergencies. A new study finds that when they offer weekly visits to seniors and those in social housing, they can help improve their health and slash the number of calls made to 911.
The study looked at a program called Community Paramedicine at Clinic, or CP@Clinic. The project, which began several years ago, sees paramedics in Hamilton, Ont., drop in once a week to subsidized housing buildings that have high proportions of seniors.
They then use their skills to offer the residents basic health care, such as blood pressure and diabetes checks, conduct risk assessment for falls, as well as hold group health education workshops in the buildings’ common areas.
In some cases, the paramedics identify patients at high risk of a health crisis and refer them for further care, but in all cases, they stay in touch with the residents’ regular family physicians to let them know how they’re doing.
Researchers at McMaster University recently decided to assess how well the program has been doing by looking at the health of residents in three buildings that received these CP@Clinic visits for one year, and comparing them to residents from three buildings that didn’t.
They found significantly fewer emergency ambulance calls were made by residents at the buildings that got the weekly visits -- 3.1 calls per 100 units per month, compared with 3.99 calls per 100 units per month at the other buildings.
That’s a drop of 22 per cent, which translates into big savings for the health system, says lead researcher Dr. Gina Agarwal of McMaster’s Department of Family Medicine.
“If we estimate that a 911 call in dollar terms could cost anything between $500 to $2,500… you could save up to $25,000 or more per annum with this program in one single social housing building,” she told CTV News. “So you can imagine if you multiply, and the program was in 10 buildings, that’s a lot of money.”
Agarwal says it’s well documented that there are simply more 911 calls from social housing from people who can’t access the health system in other ways. But she says it’s an expensive way to get medical care.
“It’s not a good use of resources if somebody’s calling 911 when they could go and see their family physician,” she says. “Probably, many of the calls emanating from a social housing would be things that could be dealt with in other ways.”
The paramedics were also able to pick up undiagnosed high blood pressure in 36 participants and elevated blood pressure in another 75 people who knew they had hypertension.
The residents who got the visits also showed significant improvement in their quality of life and were better able to perform day-to-day activities compared with those in the other buildings that didn’t receive the extra care.
Tom Barrow, 67, told CTV News that he likes the program because of how “easy” it is to get health checkups where he lives.
“I went into the program because I’m on blood pressure pills,” he said. “I think it’s a great idea.”
Heidi Weber, 76, also deals with high blood pressure.
“I usually come every week,” she told CTV News after getting her blood pressure checked. “It’s easier for us -- (we) just have to come down.”
For veteran Hamilton paramedic Chris Bayards, the program makes a lot of sense, preventing chronic illnesses from worsening to an emergency situation that requires a call to 911.
“This is proactive,” he told CTV News. “We’re trying to get ahead of the problems. We’re trying to get ahead of any medical issues that could become potentially lethal.”
Bayards explained that there are many frequent users of paramedics, many who are lonely or isolated who have no one else to call for non-emergency help.
“If they don’t have a family doctor or a method to get to a doctor, then they utilize us as a method of getting to the hospital to seek out a doctor,” he said. “(If) they don’t have family, they don’t have anyone to care for them. So we become… their family. But for lack of a better word, that’s what we become.”
Many of the paramedics who took part in the study were on “modified work assignments” because they were injured or unable to perform their full paramedic duties. Such workers have the skills and knowledge to conduct risk assessments and help at-risk residents access health care.
“This is another avenue for us to still maintain our paramedical skills,” Bayards said. “However, you’re doing things in a different way.”
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip