Pilot Programs Across California Aim To Address ED ‘Super-Utilizers’
In pilot programs across California, paramedics increasingly are working to treat patients before they need emergency care in an effort to cut down on so-called "super-utilizers," the Los Angeles Times reports.
Details of Programs
According to the Times, several counties have implemented pilot programs that deploy such "community paramedics" to prevent, rather than respond to, emergencies. For example:
- Los Angeles County is implementing two programs next month, one of which will allow paramedics in Glendale to visit and monitor patients with congestive heart failure within three days of being discharged from the hospital; and
- Ventura County runs a program under which paramedics administer tuberculosis medication, while another program in the county sends paramedics to the homes of hospice patients.
Implications
State health officials hope the specially trained paramedics can help curb health care spending by focusing treatment efforts on "super-utilizers," who often have chronic conditions that frequently send them to the emergency department, according to the Times.
Experts say that allowing paramedics to visit patients at home and act as health coaches is less costly than using registered nurses or physicians. According to the U.S. Bureau of Labor Statistics, the average annual income for a paramedic is $35,720, compared with $98,400 for a registered nurse.
Proponents say that paramedics undergo sufficient training to keep patients safe. However, some stakeholders have raised concerns about the programs.
Janet Haebler, senior associate director of state government affairs at the American Nurses Association, said such programs need better regulations that ensure paramedics are:
- Communicating with nurses; and
- Integrated into the medical system.
In 2017, UC-San Francisco researchers plan to measure the success of such programs (Karlamangla, Los Angeles Times, 8/25).
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