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TL;DR
A cluster randomized trial in two rural Oregon counties tested a community paramedicine intervention for 102 high-utilizing Medicaid patients. The intervention reduced emergency medicine ED visits by 13.9% and avoidable ED visits by 38.9%.
Journal of the American College of Emergency Physicians Open · 6 authors, 4 centres
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A cluster randomized trial in two rural Oregon counties tested a community paramedicine intervention for 102 high-utilizing Medicaid patients. The intervention reduced emergency medicine ED visits by 13.9% and avoidable ED visits by 38.9%.
This study used a pragmatic cluster randomized stepped-wedge trial in two rural Oregon counties to evaluate a community paramedicine intervention for 102 Medicaid beneficiaries with complex conditions and high ED use. Community paramedics conducted weekly home visits to monitor health, coordinate care, and manage chronic conditions. The primary outcomes were emergency medicine ED visits and avoidable ED visits. Limitations include variation in the duration of intervention periods and the absence of a real-time comparator in the final period. The findings suggest community paramedicine is a feasible model to reduce non-urgent ED use among medically complex patients by providing home-based care, though policy changes for reimbursement may be needed for sustainability.