Populations that May Benefit from Community Paramedicine Programs
Community paramedicine programs can increase access to primary care services for people living in medically underserved areas, people with limited mobility, and people who can benefit from increased care coordination. This section highlights specific populations that could benefit from this increased level of care. These populations include:
People Living with Chronic Diseases
Chronic disease is a significant cause of disability and poor health in rural areas, where about 28% of residents had at least two chronic conditions in 2016. Many of these patients with chronic diseases are older adults (aged 65 and older). For people who have multiple chronic conditions or conditions that are difficult to manage, they may rely on emergency services when they are experiencing challenges that could be addressed through primary care services like medication management. Community paramedicine programs can provide mobile, non-emergency care to fill that gap. For example, in a study from Regions Hospital in Minnesota, community paramedics helped patients with diabetes and hypertension reduce their blood pressure and blood sugar. Through this program, 62% of patients saw decreased blood pressure levels and 78% of patients saw decreased blood sugar levels.
Community paramedicine programs involve community paramedics traveling within their communities to provide care in a way that is convenient for patients. The American Academy of Home Care Medicine recognizes that this model lends itself well to patient populations that are homebound. Trained paramedics are able to visit these homebound patients and provide them with medical care, without needing to immediately transport them to the emergency room for services that may be more intensive, costly, or complex than needed. For example, the Minnesota Department of Health highlights how community paramedics could help patients with their medical equipment. If it is within their program's practice guidelines, community paramedics can also provide palliative or hospice care, when appropriate.
Frequent Users of 911 with Non-Emergent Needs
The California Health Care Foundation shares how the Alameda Fire Department community paramedicine project is addressing 911 calls from individuals who need services other than emergency medical care. These may be people with complex medical or mental health conditions who would benefit from care coordination, behavioral health, or primary care services. Community paramedics can help frequent 911 callers with non-emergent needs by connecting them with appropriate health or social services, which can lead to a decrease in the number of emergency calls.
Frail or Older Adults
Older adults and individuals in frail physical condition may not be able to access proper healthcare and may live in homes that are not properly equipped to minimize fall or injury risk. A case study in Nebraska describes a community paramedicine program that provides assistance to these populations by performing home safety inspections, during which paramedics install smoke alarms and support bars so residents can more easily navigate through their homes. Additionally, community paramedics can support medication compliance for these populations and help families identify patients who would be best served in a nursing home or assisted living environment.
Patients Recently Discharged from the Hospital
The Center for Healthcare Quality and Payment Reform reports that within 30 days of discharge, 15% to 25% of patients are readmitted to the hospital. Preventable readmissions of patients recently discharged from the hospital cost the U.S. healthcare system $41.3 billion in 2011, according to the California Health Care Foundation. Some of these readmissions are due to a lack of understanding by the patient or clear instruction from the hospital about how to transition to appropriately caring for their condition on their own, which can be addressed with the help of a community paramedic. Community paramedics can visit the patient's home and schedule follow-up calls and visits to the patient while they are transitioning back to their life at home. The community paramedic can help with adherence to the discharge information, medication management, and scheduling follow-up appointments.
Tribal populations may live in remote areas and have limited access to healthcare. This distance can result in delays to accessing care or unmet needs for preventive and primary care services. Community paramedicine programs can provide mobile primary care services, as demonstrated by the Pueblo of Laguna, New Mexico. Services include medication management and wound care directly in patients' homes or other non-clinical locations, helping patients receive more timely care and avoiding the need to travel long distances to visit the hospital or clinic.
Resources to Learn More
Program Strengthens Rural Health Care System
Describes a community paramedicine program implemented in rural Nebraska. The program, funded by the Community Hospital Health Foundation, provided free health services to recently hospitalized patients including safety assessments and help with activities of daily living.
Organization(s): Bryan Health, Community Hospital, Community Hospital Health Foundation, McCook Clinic PC, City of McCook Fire Department
Hospital Community Paramedicine Program Improves Care for Diabetes and Heart Disease
Describes the success of community paramedics and community health workers in St. Paul, Minnesota in reducing blood sugar for patients with diabetes and blood pressure for patients with hypertension.