A Retrospective Cohort Study of Health Service Utilization and Costs of People Experiencing Homelessness Following Community Paramedic Care
Date
2021-09-22
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Abstract
The City Centre Team (CCT) is a community paramedic program that delivers care to people experiencing homelessness in Calgary, Canada. This study compares the rates and characteristics of health service utilization and the associated costs of patients interacting with the service by linking multiple administrative databases (including hospitalizations, emergency department and urgent care centre visits, emergency medical services (EMS) events, physician claims, and pharmaceutical dispensations) in a pre-post retrospective cohort study. The primary outcome is the difference in ambulatory care sensitive condition-related hospitalizations in the year preceding the initial CCT visit and in the following year. Secondary outcomes are the differences between periods of all-cause hospitalizations, emergency department and urgent care centre visits, EMS events, physician claims, pharmaceutical dispensations, and costs. In the post-period, CCT patients had increased ambulatory care sensitive condition-related hospitalizations and associated costs compared to the pre-period. Except for all-cause hospitalizations, there was increased utilization and costs of health services between periods, with significant increases in community-based care in those that were previously underserved. The study characterizes and shows the impact on health service utilization in the initial 18-months of a community paramedic program directed at people experiencing homelessness. These findings inform decision-makers of a health service that can be developed in response to the complex health needs of an underserved population using community paramedics.
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Keywords
Community Paramedic, Mobile Integrated Health, Prehospital Care, Homelessness
Citation
Taplin, JG. (2021). A Retrospective Cohort Study of Health Service Utilization and Costs of People Experiencing Homelessness Following Community Paramedic Care (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.