ABSTRACTS
Putting the “I” in Mobile Integrated Healthcare: Measuring System-Wide Outcomes and Cost Savings Resulting from Community Paramedic Interventions Within a Local HealthcareAuthor: Alice Harvey, RN, BSN, MSN | | Associate Authors:
Introduction Limited data exists illustrating the clinical and financial value of community paramedic (CP) interventions in rural communities. In this study, we analyze outcomes for specific populations receiving four CP services: chronic disease management (CDM), acute care follow-up (ACF), crisis co-response (CCR), and home safety assessment (HSA). Objective To examine average cost of care and clinical incidence data for CP interventions to illustrate potential system savings. Methods A retrospective correlational case study was performed for Eagle County, Colorado, based on 86 total patients receiving specified services during the third and fourth quarters of 2022. Outcome variables and measurement were derived from national quality measures, including MIPS and HRRP. Statistical methods include calculation of potential cost savings using both local and national estimates of clinical incidence rates and average cost of care. Additional analysis is required to confirm statistical significance for this study. Multiple limitations were identified, including small sample size, limited existing control data, and limited longitudinal patient data. Results Of the 86 cases analyzed, 64% of CDM patients had no acute exacerbation within 3 months; 82% of HSA patients had no subsequent falls within 6 months; 89% of ACF patients avoided readmission within 30 days; and 82% of CCR patients avoided transport to the hospital. These rates were compared to control outcome percentages and the difference in average cost of care was then calculated using the control and observed percent post-CP intervention. Estimated total potential cost savings for 86 patients was calculated at $378,019.76 over a 6-month period, which averages $4,395.58 per patient. Conclusion Despite multiple limitations in available control data, it is clear that the studied CP interventions increase the incidence of positive quality outcomes related to national quality measures for ACF, CCR and CDM; however, no significant impact was observed with HSA due to a need for additional analysis of actual incidence within the referred population. These findings have been substantiated by local hospital research, attributing lower readmission rates to an increase in CP referrals over the past 3 years. Actual cost savings are significant and exceed current cost of service provision.
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