Lauri J Mäki, Perttu J Kontunen, Johanna M Kaartinen, Maaret K Castrén
{"title":"基于价值的老年人护理急性外展服务单位对紧急医疗服务任务的影响:一项准实验研究。","authors":"Lauri J Mäki, Perttu J Kontunen, Johanna M Kaartinen, Maaret K Castrén","doi":"10.1111/scs.13220","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit \"Mobile hospital\" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.</p><p><strong>Methods: </strong>This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.</p><p><strong>Results: </strong>Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.</p><p><strong>Conclusions: </strong>LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Value-based care of older people-The impact of an acute outreach service unit on emergency medical service missions: A quasi-experimental study.\",\"authors\":\"Lauri J Mäki, Perttu J Kontunen, Johanna M Kaartinen, Maaret K Castrén\",\"doi\":\"10.1111/scs.13220\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit \\\"Mobile hospital\\\" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.</p><p><strong>Methods: </strong>This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.</p><p><strong>Results: </strong>Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.</p><p><strong>Conclusions: </strong>LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.</p>\",\"PeriodicalId\":48171,\"journal\":{\"name\":\"Scandinavian Journal of Caring Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Scandinavian Journal of Caring Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/scs.13220\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/10/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Scandinavian Journal of Caring Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/scs.13220","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/8 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Value-based care of older people-The impact of an acute outreach service unit on emergency medical service missions: A quasi-experimental study.
Background: Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit "Mobile hospital" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.
Methods: This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.
Results: Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.
Conclusions: LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.
期刊介绍:
Scandinavian Journal of Caring Sciences is an established quarterly, peer reviewed Journal with an outstanding international reputation. As the official publication of the Nordic College of Caring Science, the Journal shares their mission to contribute to the development and advancement of scientific knowledge on caring related to health, well-being, illness and the alleviation of human suffering. The emphasis is on research that has a patient, family and community focus and which promotes an interdisciplinary team approach. Of special interest are scholarly articles addressing and initiating dialogue on theoretical, empirical and methodological concerns related to critical issues. All articles are expected to demonstrate respect for human dignity and accountability to society. In addition to original research the Journal also publishes reviews, meta-syntheses and meta-analyses.