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- Title
Value‐based care of older people—The impact of an acute outreach service unit on emergency medical service missions: A quasi‐experimental study.
- Authors
Mäki, Lauri J.; Kontunen, Perttu J.; Kaartinen, Johanna M.; Castrén, Maaret K.
- 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.
- Subjects
FINLAND; EVALUATION of medical care; BUSINESS management of health facilities; EVALUATION of human services programs; CONFIDENCE intervals; AMBULANCES; RESEARCH methodology; MOBILE hospitals; HOSPITAL health promotion programs; MANN Whitney U Test; VALUE-based healthcare; COMPARATIVE studies; PEARSON correlation (Statistics); CRITICAL care medicine; RESIDENTIAL care; CHI-squared test; DESCRIPTIVE statistics; RESEARCH funding; DATA analysis software; ELDER care; GOAL (Psychology); EMERGENCY medicine; EVALUATION; OLD age
- Publication
Scandinavian Journal of Caring Sciences, 2024, Vol 38, Issue 1, p169
- ISSN
0283-9318
- Publication type
Article
- DOI
10.1111/scs.13220