Community paramedicine program and outcomes of referred coronary artery bypass grafting patients.

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Rural and remote health Pub Date : 2024-10-01 Epub Date: 2024-10-17 DOI:10.22605/RRH8977
Regan Washist, Casey Smith, Tyler Kientopf
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Abstract

Introduction: Community paramedicine is a field in its infancy. The use of community paramedics has expanded in recent years as an alternative or adjunct to home health in the continued drive to decrease health disparities and complications. In current practice, they function in a position like a home healthcare nurse with an expanded scope of practice, such as providing specialized follow-up care, for example with postoperative care for patients who have undergone major surgery or recent hospitalization. This study assesses if community paramedics are a valid option in reducing rehospitalization of patients who underwent a coronary artery bypass grafting (CABG) procedure.

Methods: A retrospective chart review between 2021 and 2022 was performed on all patients who underwent CABG in Bismarck, North Dakota, along with obtaining a referral for the community paramedics spanning urban and rural areas. A comparison was made between individuals who saw the community paramedics in their post-care versus those who continued with the standard of care.

Results: There were 80 participants and 38 location-matched controls. All variables were found to be statistically insignificant except for the number of walk-in visits (urgent care), in which 7 out of 38 sought medical attention in the controls and 4 out of 80 sought medical attention in the participants. The proportions of inpatient readmission rates and emergency department (ED) visits were similar.

Discussion: Given that paramedicine is in its infancy, the emergence of other variations of the community paramedic certification has brought a discussion of their scope of practice. While walk-in visits, even with the limitations, showed significant improvement with the addition of community paramedics, more research is still needed to show their effectiveness in reducing readmission to hospital. Additionally, the patients who sought help from community paramedics may be more likely than the controls to seek help from medical professionals.

Conclusion: This study provided a novel look into the effect that community paramedics can have on patients in urban and rural areas in regard to reducing postoperative complications and minimizing unnecessary advanced healthcare utilization.

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社区辅助医疗计划与转诊冠状动脉旁路移植术患者的治疗效果。
引言社区辅助医疗尚处于起步阶段。近年来,社区辅助医务人员的使用范围不断扩大,成为家庭保健的替代或辅助手段,以持续减少健康差异和并发症。在目前的实践中,他们的职能类似于家庭保健护士,但业务范围有所扩大,例如为接受过大手术或近期住院的患者提供专门的后续护理。本研究评估了社区护理人员是否是减少冠状动脉旁路移植术(CABG)患者再次住院的有效选择:方法:对北达科他州俾斯麦市 2021 年至 2022 年期间接受 CABG 手术的所有患者进行了回顾性病历审查,同时获得了城市和农村地区社区护理人员的转诊信息。对在术后接受社区护理人员治疗的患者与继续接受标准治疗的患者进行了比较:共有 80 名参与者和 38 名地点匹配的对照组。所有变量在统计学上均无差别,但无预约就诊(紧急护理)次数除外,对照组 38 人中有 7 人就医,而参与者 80 人中有 4 人就医。住院病人再入院率和急诊室就诊率的比例相似:鉴于辅助医务人员尚处于起步阶段,社区辅助医务人员认证的其他变体的出现带来了对其执业范围的讨论。尽管社区辅助医务人员的加入使走入式就诊有了明显改善,但仍需进行更多的研究来证明他们在减少再次入院方面的有效性。此外,与对照组相比,向社区护理人员求助的患者可能更倾向于向医疗专业人员求助:这项研究提供了一个新的视角,让我们了解社区护理人员在减少术后并发症和尽量减少不必要的高级医疗保健使用方面对城市和农村地区患者的影响。
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来源期刊
Rural and remote health
Rural and remote health Rural Health-
CiteScore
2.00
自引率
9.50%
发文量
145
审稿时长
8 weeks
期刊介绍: Rural and Remote Health is a not-for-profit, online-only, peer-reviewed academic publication. It aims to further rural and remote health education, research and practice. The primary purpose of the Journal is to publish and so provide an international knowledge-base of peer-reviewed material from rural health practitioners (medical, nursing and allied health professionals and health workers), educators, researchers and policy makers.
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