Background: Researchers conducted a randomized clinical trial to test whether a program called Care Anywhere with Community Paramedics (CACP) could shorten or prevent hospital use. The study enrolled 240 adults receiving care through Mayo Clinic sites in Minnesota and Wisconsin. Study participants needed medical services that could be delivered by community paramedics at home but would have otherwise required hospital-based care. Participants were randomly assigned to receive either CACP care or usual care pathways. The primary outcome was days alive outside the hospital or emergency department within 30 days.
What They Found: The number of days alive outside the hospital or emergency department did not differ between groups. Participants receiving community paramedic care averaged 26.7 days, compared with 27.9 days for those receiving usual care. Rates of emergency department visits, unplanned hospitalizations, and death during the 30-day follow-up period also did not differ between groups. However, participants who received community paramedic care reported higher satisfaction with their care, and nearly all said they would recommend the program. Patients in both study groups preferred future care to be delivered in a home setting like the community paramedic program.
Implications: The CACP program, which enrolled highly complex patients with heterogeneous care needs, did not decrease 30-day acute care use compared with alternative usual care pathways, but it improved patient satisfaction and was preferred by most participants.
Rozalina G. McCoy, MD, MS, et al
University of Maryland Institute for Health Computing, North Bethesda, Maryland
