Mobile integrated health to reduce post-discharge acute care visits

A pilot study

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 patient 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) 90. days before MIH intervention to 90. days 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.

Original languageEnglish (US)
JournalAmerican Journal of Emergency Medicine
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Subacute Care
Telemedicine
Observation
Inpatients
Hospitalization
Emergency Medical Technicians
Delivery of Health Care
Allied Health Personnel
Quality Improvement
Primary Health Care
Cohort Studies

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

@article{b171f564fc0245d28cfffddfb3b15bed,
title = "Mobile integrated health to reduce post-discharge acute care visits: A pilot study",
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 patient 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) 90. days before MIH intervention to 90. days 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.",
author = "Jennica Siddle and Peter Pang and Christopher Weaver and Elizabeth Weinstein and Daniel O'Donnell and Arkins, {Thomas P.} and Charles Miramonti",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ajem.2017.12.064",
language = "English (US)",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Mobile integrated health to reduce post-discharge acute care visits

T2 - A pilot study

AU - Siddle, Jennica

AU - Pang, Peter

AU - Weaver, Christopher

AU - Weinstein, Elizabeth

AU - O'Donnell, Daniel

AU - Arkins, Thomas P.

AU - Miramonti, Charles

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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 patient 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) 90. days before MIH intervention to 90. days 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.

AB - 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 patient 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) 90. days before MIH intervention to 90. days 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.

UR - http://www.scopus.com/inward/record.url?scp=85040074202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040074202&partnerID=8YFLogxK

U2 - 10.1016/j.ajem.2017.12.064

DO - 10.1016/j.ajem.2017.12.064

M3 - Article

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

ER -