Dataset Information

Community paramedicine: cost-benefit analysis and safety evaluation in paramedical emergency services in rural areas - a scoping review.

ABSTRACT:

Objective

To examine the current knowledge and possibly identify gaps in the knowledge base for cost-benefit analysis and safety concerning community paramedicine in rural areas.

Design

Scoping review.

Data sources

MEDLINE via PubMed, CINAHL, Cochrane and Embase up to December 2020.

Study selection

All English studies involving community paramedicine in rural areas, which include cost-benefit analysis or safety evaluation.

Data extraction

This scoping review follows the methodology developed by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We systematically searched for all types of studies in the databases and the reference lists of key studies to identify studies for inclusion. The selection process was in two steps. First, two reviewers independently screened 2309 identified articles for title and abstracts and second performed a full-text review of 24 eligible studies for inclusion.

Results

Three articles met the inclusion criteria concerning cost-benefit analysis, two from Canada and one from USA. No articles met the inclusion criteria for safety evaluation.

Conclusion

There are knowledge gaps concerning safety evaluation of community paramedicine in rural areas. Three articles were included in this scoping review concerning cost-benefit analysis, two of them showing positive cost-effectiveness with community paramedicine in rural areas.

SUBMITTER: Elden OE

PROVIDER: S-EPMC9185415 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Community paramedicine: cost-benefit analysis and safety evaluation in paramedical emergency services in rural areas - a scoping review.

Elden Odd Eirik OE Uleberg Oddvar O Lysne Marianne M Haugdahl Hege Selnes HS

BMJ open 20220609 6

<h4>Objective</h4>To examine the current knowledge and possibly identify gaps in the knowledge base for cost-benefit analysis and safety concerning community paramedicine in rural areas.<h4>Design</h4>Scoping review.<h4>Data sources</h4>MEDLINE via PubMed, CINAHL, Cochrane and Embase up to December 2020.<h4>Study selection</h4>All English studies involving community paramedicine in rural areas, which include cost-benefit analysis or safety evaluation.<h4>Data extraction</h4>This scoping review f ...[more]

PMID: 35680256

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Project description:IntroductionCommunity paramedicine models have been developed around the world in response to demographic changes, healthcare system needs and reforms. The traditional role of the paramedic has primarily been to provide emergency medical response and transportation of patients to nearby medical facilities. As a response to healthcare service gaps in underserved communities and the growing professionalisation of the workforce, the role of community paramedicine has evolved as a new model of care. A community paramedicine model in one region might address other healthcare needs than a model in another region. Various terms are also in use for community paramedicine providers, with no consensus on the definition for community paramedics, although the definition used by the International Roundtable on Community Paramedicine has been widely accepted. We aimed to examine the current knowledge and possibly identify gaps in the research/knowledge base for cost-benefit analysis and safety concerning community paramedicine in rural areas using a scoping review methodology.Methods and analysisThis scoping review will follow the methodology developed by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. In October 2020, we will search electronic databases (MEDLINE via PubMed, CINAHL, Cochrane and Embase) and the reference lists of key studies to identify studies for inclusion. The selection process is in two steps. First, two reviewers will independently screen identified articles for title and abstracts and, second, perform a full-text review of eligible studies for inclusion. Studies focusing on community paramedicine in rural areas, which include cost-benefit analysis or safety evaluation, will be included.Ethics and disseminationThe data used are available from publicly secondary sources, therefore this study will not require ethical review. The results will be disseminated through peer-reviewed publication.

Project description:BackgroundThere is a disparity in outcomes between rural and urban emergency medical services (EMS) around the world. However, there is a scarcity of research that directly asks EMS staff in both rural and urban areas how service delivery could be improved. The aim of the present study is to gain insights from frontline workers regarding organisational factors that may underpin discrepancies between rural and urban EMS performance.Subject and methodsThe study was undertaken in the Riyadh region of Saudi Arabia. Potential participants were currently employed by Saudi Red Crescent EMS as either a technician, paramedic or an EMS station manager, and had a minimum of five years experience with the EMS. Semi-structured interviews were undertaken between October 2019 and July 2020 with first respondents to a call for participants, and continued until data saturation was reached. All interviews were conducted in Arabic and transcribed verbatim. The Arabic transcript was shared with each participant, and they were asked to confirm their agreement with the transcription. The transcribed interviews were then translated into English; the English versions were shared with bi-lingual participants for validation, while independent certification of the translations were performed for data from participants not fluent in English. A thematic analysis methodological approach was used to examine the data.ResultsThe final sample involved 20 participants (10 rural, 10 urban) from Saudi Red Crescent EMS. Data analyses identified key organisational factors that resulted in barriers and impediments for EMS staff. Differences and similarities were observed between rural and urban respondents, with identified issues including response and transportation time, service coordination, reason for call-out, as well as human and physical resourcing.ConclusionThe findings identified key issues impacting on EMS performance across both rural and urban areas. In order to address these problems, three changes are recommended. These recommendations include a comprehensive review of rural EMS vehicles, with a particular focus on the age; incentives to improve the numbers of paramedics in rural areas and more localised specialist training opportunities for rurally-based personnel; and the implementation of national public education program focusing on the role of the EMS.

Project description:ImportanceIn recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services.ObjectiveTo conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses.Design, setting, and participantsStandard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year.InterventionsSchool health services provided by full-time registered nurses.Main outcomes and measuresCosts of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars.ResultsDuring the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit.Conclusions and relevanceThe results of this study demonstrated that school nursing services provided in the Massachusetts ESHS schools were a cost-beneficial investment of public money, warranting careful consideration by policy makers and decision makers when resource allocation decisions are made about school nursing positions.

Project description:ObjectivesThe aim of this study was to map existing emergency medical services (EMS) and palliative care literature by answering the question, what literature exists concerning EMS and palliative care? The sub-questions regarding this literature were, (1) what types of literature exist?, (2) what are the key findings? and (3) what knowledge gaps are present?DesignA scoping review of literature was performed with an a priori search strategy.Data sourcesMEDLINE via Pubmed, Web of Science, CINAHL, Embase via Scopus, PsycINFO, the University of Cape Town Thesis Repository and Google Scholar were searched.Eligibility criteria for selecting studiesEmpirical, English studies involving human populations published between 1 January 2000 and 24 November 2022 concerning EMS and palliative care were included.Data extraction and synthesisTwo independent reviewers screened titles, abstracts and full texts for inclusion. Extracted data underwent descriptive content analysis and were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines.ResultsIn total, 10 725 articles were identified. Following title and abstract screening, 10 634 studies were excluded. A further 35 studies were excluded on full-text screening. The remaining 56 articles were included for review. Four predominant domains arose from included studies: (1) EMS' palliative care role, (2) challenges faced by EMS in palliative situations, (3) EMS and palliative care integration benefits and (4) proposed recommendations for EMS and palliative care integration.ConclusionEMS have a role to play in out-of-hospital palliative care, however, many challenges must be overcome. EMS provider education, collaboration between EMS and palliative systems, creation of EMS palliative care guidelines/protocols, creation of specialised out-of-hospital palliative care teams and further research have been recommended as solutions. Future research should focus on the prioritisation, implementation and effectiveness of these solutions in various contexts.

Project description:ObjectiveTo map what is currently known about knowledge translation (KT) in Anglo-American paramedicine. The review focuses on reported barriers and facilitators to the implementation of new knowledge, and the use of models, theories and frameworks to guide implementation practice.DesignScoping review reported as per both the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines.Data sourcesCINAHL (EBSCO Host) and Medline (OVID interface) were searched from January 2000 to May 2023. Reference lists of all included papers were reviewed, and several key professional journals were hand-searched.Eligibility criteria for selecting studiesPrimary sources that focused on KT models, theories or frameworks, or barriers and facilitators to KT implementation, involving paramedics or Emergency Medical Technicians (Paramedic in America) working in an out-of-hospital, Anglo-American Emergency Medical Service (EMS) system were eligible for inclusion.Data extraction and synthesisOne reviewer used a data extraction template developed for this review and 10% of the papers were checked by the second author. Findings were summarised in tables and synthesised both quantitatively and qualitatively.ResultsThe search yielded 1268 primary sources, of which 48 were included in the review. Thirty-two papers examining KT interventions and 16 papers examining the barriers and facilitators to KT were found. Only one randomised controlled trial was found, and only one paper made explicit use of any KT framework. Overall, eight themes describing barriers and facilitators to KT arose from the qualitative literature, with clinicians' perception of the evidence being the dominant theme. All 32 papers describing KT interventions included some form of educational intervention.ConclusionsOverall, there is little depth and breadth in the literature, with many papers focusing on trauma and airway management. There are large gaps in the evidence surrounding the use of KT theories and frameworks in Anglo-American EMS. Further research is needed to identify appropriate KT models and frameworks that are contextualised to EMS to ensure that paramedic-led research finds its way to the clinicians needing to use it.

Dataset Information

Community paramedicine: cost-benefit analysis and safety evaluation in paramedical emergency services in rural areas - a scoping review.

Objective

Design

Data sources

Study selection

Data extraction

Results

Conclusion

Publications

Community paramedicine: cost-benefit analysis and safety evaluation in paramedical emergency services in rural areas - a scoping review.

Similar Datasets

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