Jennica Siddle1, Peter S Pang2, Christopher Weaver1, Elizabeth Weinstein3, Daniel O'Donnell3, Thomas P Arkins4, Charles Miramonti5. 1. Indiana University School of Medicine, Indianapolis, IN, United States. 2. Indiana University School of Medicine, Indianapolis, IN, United States; Indianapolis EMS, Indianapolis, IN, United States. Electronic address: ppang@iu.edu. 3. Indiana University School of Medicine, Indianapolis, IN, United States; Indianapolis EMS, Indianapolis, IN, United States. 4. Indianapolis EMS, Indianapolis, IN, United States. 5. Indiana University School of Medicine, Indianapolis, IN, United States; Indianapolis EMS, Indianapolis, IN, United States; Eskenazi Health, Indianapolis, IN, United States.
Abstract
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care. The primary outcome compared acute care utilization (ED visits, observation stays, inpatient visits) 90days before MIH intervention to 90days after. RESULTS: Of the 203 patients seen by MIH teams, inpatient utilization decreased significantly from 140 hospitalizations pre-MIH to 26 post-MIH (83% reduction, p=0.00). ED and observation stays, however, increased numerically, but neither was significant. (ED 18 to 19 stays, p=0.98; observation stays 95 to 106, p=0.30) Primary care visits increased 15% (p=0.11). CONCLUSION: In this pilot before/after study, MIH significantly reduces acute care hospitalizations.
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care. The primary outcome compared acute care utilization (ED visits, observation stays, inpatient visits) 90days before MIH intervention to 90days after. RESULTS: Of the 203 patients seen by MIH teams, inpatient utilization decreased significantly from 140 hospitalizations pre-MIH to 26 post-MIH (83% reduction, p=0.00). ED and observation stays, however, increased numerically, but neither was significant. (ED 18 to 19 stays, p=0.98; observation stays 95 to 106, p=0.30) Primary care visits increased 15% (p=0.11). CONCLUSION: In this pilot before/after study, MIH significantly reduces acute care hospitalizations.
Authors: Anita D Misra-Hebert; Michael B Rothberg; Jaqueline Fox; Xinge Ji; Bo Hu; Alex Milinovich; William Zafirau; Anthony Onuzuruike; Kurt C Stange Journal: Healthc (Amst) Date: 2021-01-04
Authors: Ji Yeong Soh; Se Uk Lee; Inpyo Lee; Ki Sang Yoon; Changho Song; Nam Hun Kim; Tae Sung Sohn; Jae Moon Bae; Dong Kyung Chang; Won Chul Cha Journal: JMIR Mhealth Uhealth Date: 2019-02-19 Impact factor: 4.773