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dc.contributor.authorDixon, S.
dc.contributor.authorMason, Suzanne
dc.contributor.authorKnowles, Emma
dc.contributor.authorColwell, B.
dc.contributor.authorWardrope, Jim
dc.contributor.authorSnooks, Helen
dc.contributor.authorGorringe, R.
dc.contributor.authorPerrin, J.
dc.contributor.authorNicholl, Jon
dc.date.accessioned2020-07-28T13:19:42Z
dc.date.available2020-07-28T13:19:42Z
dc.date.issued2009-05-22
dc.identifier.citationDixon, S. et al, 2009. Is it cost effective to introduce paramedic practitioners for older people to the ambulance service? Results of a cluster randomised controlled trial. Emergency Medicine Journal, 26 (6), 446-451.en_US
dc.identifier.issn1472-0205
dc.identifier.issn1472-0213
dc.identifier.doi10.1136/emj.2008.061424
dc.identifier.urihttp://hdl.handle.net/20.500.12417/847
dc.description.abstractBackground: A scheme to train paramedics to undertake a greater role in the care of older people following a call for an emergency ambulance was developed in a large city in the UK. Objectives: To assess the cost effectiveness of the paramedic practitioner (PP) scheme compared with usual emergency care. Methods: A cluster randomised controlled trial was undertaken of PP compared with usual care. Weeks were allocated to the study group at random to the PP scheme either being active (intervention) or inactive (control). Resource use data were collected from routine sources, and from patient-completed questionnaires for events up to 28 days. EQ-5D data were also collected at 28 days. Results: Whereas the intervention group received more PP contact time, it reduced the proportion of emergency department (ED) attendances (53.3% vs 84.0%) and time in the ED (126.6 vs 211.3 minutes). There was also some evidence of increased use of health services in the days following the incident for patients in the intervention group. Overall, total costs in the intervention group were £140 lower when routine data were considered (p = 0.63). When the costs and QALY were considered simultaneously, PP had a greater than 95% chance of being cost effective at £20 000 per QALY. Conclusion: Several changes in resource use are associated with the use of PP. Given these economic results in tandem with the clinical, operational and patient-related benefits, the wider implementation and evaluation of similar schemes should be considered. https://emj.bmj.com/content/26/6/446. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2008.061424
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectParamedic Practiceen_US
dc.subjectAmbulance Servicesen_US
dc.subjectGeriatric Medicineen_US
dc.subjectCost-Benefit Analysisen_US
dc.titleIs it cost effective to introduce paramedic practitioners for older people to the ambulance service? Results of a cluster randomised controlled trialen_US
dc.typeJournal Article/Review
dc.source.journaltitleEmergency Medicine Journalen_US
dcterms.dateAccepted2020-07-17
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2020-07-17
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2009-05-22
html.description.abstractBackground: A scheme to train paramedics to undertake a greater role in the care of older people following a call for an emergency ambulance was developed in a large city in the UK. Objectives: To assess the cost effectiveness of the paramedic practitioner (PP) scheme compared with usual emergency care. Methods: A cluster randomised controlled trial was undertaken of PP compared with usual care. Weeks were allocated to the study group at random to the PP scheme either being active (intervention) or inactive (control). Resource use data were collected from routine sources, and from patient-completed questionnaires for events up to 28 days. EQ-5D data were also collected at 28 days. Results: Whereas the intervention group received more PP contact time, it reduced the proportion of emergency department (ED) attendances (53.3% vs 84.0%) and time in the ED (126.6 vs 211.3 minutes). There was also some evidence of increased use of health services in the days following the incident for patients in the intervention group. Overall, total costs in the intervention group were £140 lower when routine data were considered (p = 0.63). When the costs and QALY were considered simultaneously, PP had a greater than 95% chance of being cost effective at £20 000 per QALY. Conclusion: Several changes in resource use are associated with the use of PP. Given these economic results in tandem with the clinical, operational and patient-related benefits, the wider implementation and evaluation of similar schemes should be considered. https://emj.bmj.com/content/26/6/446. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2008.061424en_US


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