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dc.contributor.authorLeyenaar, Matthew S
dc.contributor.authorTavares, Walter
dc.contributor.authorAgarwal, Gina
dc.contributor.authorCosta, Andrew P
dc.date.accessioned2019-03-08T12:12:52Z
dc.date.available2019-03-08T12:12:52Z
dc.date.issued2019-01
dc.identifier.citationLeyenaar, M., Tavares, W., Agarwal, G., & Costa, A. (2019). Indicators of paramedic service use by community dwelling older adults. Irish Journal of Paramedicine, 4(1). doi:http://dx.doi.org/10.32378/ijp.v4i1.74en_US
dc.identifier.issn2009-938X
dc.identifier.doi10.32378/ijp.v4i1.74
dc.identifier.urihttp://hdl.handle.net/10147/624120
dc.descriptionIntroduction: Home care clients represent a patient group that may be served through community paramedicine (CP) programs. The Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale was recently validated to identify levels of risk for use of emergency care among this population. This study investigates whether frail home care clients that were identified as being at higher risk based on their DIVERT scores were more likely to use paramedic services to access the emergency department within 90 days of assessment when compared to clients that had lower DIVERT scores. Methods: A retrospective cohort study was conducted using regularly collected administrative data. Home care assessment data were supplemented with data on emergency department (ED) visits. Arrival by ambulance was modelled to control for DIVERT scores as well as several social and demographic variables. Results: Within the cohort, approximately 40% of individuals visited an ED within 90 days of a home care assessment and almost half of all individuals visited an ED more than once within a year. About two-thirds of clients that visited an ED in the 90 days following assessment used an ambulance for transportation. DIVERT scores were predictive of this use with highest scores indicating 4.15 times higher odds of paramedic service use (95% CI 3.60-4.78 Conclusion: DIVERT was not developed to consider means of transportation to the ED. The results indicate that it can be used to identify frail community dwelling older adults that are likely to use paramedic services to take them to the ED. Further investigation of aspects of social isolation, carer resiliency, time of use, and characteristics associated with ED discharge are warranted. Frequent ambulance use among this population suggests that collaboration between care providers may provide opportunities to prevent unnecessary ED visits by these individuals.en_US
dc.language.isoenen_US
dc.publisherIrish College of Paramedicsen_US
dc.relation.urlhttp://irishparamedicine.com/index.php/ijp/article/view/74en_US
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/us/*
dc.subjectEmergency department use, Paramedic service use, Repeated use, Case-finding, Risk scaleen_US
dc.subjectPARAMEDICSen_US
dc.subjectEMERGENCY SERVICESen_US
dc.subjectCOMMUNITY HEALTH SERVICESen_US
dc.subjectOLDER PEOPLEen_US
dc.titleIndicators of paramedic service use by community dwelling older adultsen_US
dc.typeArticleen_US
dc.identifier.journalIrish Journal of Paramedicineen_US
dc.source.journaltitleIrish Journal of Paramedicine
dc.source.volume4
dc.source.issue1
refterms.dateFOA2019-03-08T12:12:52Z


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