A rural community paramedicine program resulted in better health outcomes and reduced health care utilization for people with chronic conditions and who frequently visit the emergency department.

Background

Community paramedicine holds promise to enhance access to care in rural areas with limited health care providers and for people who lack reliable transportation. This study examined the impact of a community paramedicine program implemented in rural South Carolina on health care outcomes for people with at least one chronic condition and who used the emergency department at least twice within a month.  

Findings

This pre-post study included 193 patients — 68 enrolled in the program and 125 in the comparison group. Program participants had a 59% decrease in ED visits compared to a 4% increase in the comparison group, a 69% decrease in inpatient admissions compared to a 188% increase in the comparison group, and a 16% decrease in length of stay compared to a 163% increase in the comparison group. Patients with hypertension had an average systolic blood pressure decrease of 7.2 mmHg and a diastolic blood pressure decrease of 4.0 mmHg, compared to baseline. Patients with diabetes experienced an average blood glucose level decrease of 33.7 mmol/L, compared to baseline. The community paramedicine program also had high patient satisfaction and supported connections to other community resources. The study estimated that the program had a 20% return on investment.

Program/Policy Takeaways

Community paramedicine can support improved health outcomes and reduced health care utilization in rural communities. Health plans and policy makers may explore mechanisms to financially support community paramedicine in rural areas to expand access to preventive services and enhance chronic condition management.