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Methodology of a Cross-sectional Study Evaluating the Impact of a Novel Mobile Care Team on the Prevalence of Ambulatory Care Sensitive Conditions Presenting to Emergency Medical Services

机译：横断面研究的方法论该研究评估了一支新型的流动医疗团队对急诊医疗服务所需要的门诊医疗敏感状况的影响

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IntroductionHospitalization due to ambulatory care sensitive conditions (ACSC) is often used as a proxy measure for access to primary care. The prevalence of ACSC has not been measured in the prehospital setting. Emergency medical services (EMS) are being used by patients who lack access to primary care for ACSC. Many novel models of care have been implemented within Canada and internationally, utilizing paramedics to ease the burden of poor primary care access. Recently, a mobile care team (MCT) consisting of a paramedicurse configuration has been deployed in the community of New Waterford, Nova Scotia. The team responds to low acuity 911 calls and follow-up appointments booked by primary care clinicians. This study will identify the prevalence of patients with ACSC presenting to EMS before and after the implementation of MCT and the differences after the implementation of the MCT.MethodsSecondary data will be collected from the centralized EMS electronic patient care report (ePCR) database. All patients presenting to the ground ambulance with ACSC during the year prior to MCT implementation, all patients presenting to the ground ambulance with ACSC during the year post-MCT implementation, and all patients presenting to the MCT with ACSC will be included for analysis, allowing for a calculation of ACSC prevalence. Descriptive methods will be used for age, sex, primary care practitioner, and ASCS complaints. Prevalence data will be compared via the chi-squared test. A subgroup analysis of age, sex, and individual presenting conditions will also be analyzed using the chi-squared test. Confounding will be dealt with via multivariate logistic regression.ResultsThe study results are pending; however, a literature review reveals a paucity of data on ACSC in EMS.ConclusionsDue to the paucity of literature surrounding ACSC prevalence in EMS, the methodology developed to study these prevalence rates is a novel protocol of importance to prehospital research and the epidemiology of ACSC more broadly.
机译：简介由于非卧床护理敏感条件（ACSC）而导致的住院治疗通常用作获得初级护理服务的替代措施。在院前环境中尚未测量ACSC的患病率。急诊医疗服务（EMS）被无法获得ACSC初级保健的患者使用。加拿大和国际上已经采用了许多新颖的护理模式，利用护理人员来减轻难以获得初级保健的负担。最近，由护理人员/护士组成的流动护理团队（MCT）已部署在新斯科舍省新沃特福德的社区。该团队响应基层医疗医生预定的低敏911电话和随访预约。这项研究将确定实施MCT之前和之后接受EMS的ACSC患者的患病率以及实施MCT之后的差异。方法将从集中的EMS电子病历报告（ePCR）数据库中收集二次数据。在进行MCT实施前一年中所有向地面救护车上ACSC的患者，在MCT实施后一年中对地面救护车上ACSC的所有患者以及所有向ACCT向MCT求诊的患者都将进行分析，以便用于计算ACSC患病率。描述性方法将用于年龄，性别，初级保健从业人员和ASCS投诉。患病率数据将通过卡方检验进行比较。年龄，性别和个人表现状况的亚组分析也将使用卡方检验进行分析。结果将通过多因素logistic回归处理。结论：由于围绕EMS中ACSC患病率的文献匮乏，研究这些患病率的方法是一种新颖的方案，对院前研究和ACSC的流行病学具有重要意义。宽广地。

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