Evidence map›Paper›PMID 38485282›Full record

ArticleJournal of the American Geriatrics Society2024

Community paramedicine in dementia care.

Colby Parsons, Christian Escobar, Amy Jasani, Duzhi Zhao, Peter Gliatto, Erik Blutinger, Katherine A Ornstein

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Colby ParsonsDepartment of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0002-9591-5275
Christian EscobarDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Amy JasaniHeersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Duzhi ZhaoDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Peter GliattoDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Erik BlutingerDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Katherine A OrnsteinCenter for Equity in Aging, Johns Hopkins University, School of Nursing, Baltimore, Maryland, USA.
Icahn School of Medicine at Mount Sinai · USJohns Hopkins University · USUniversity of Alabama at Birmingham · US

Funding

Home, but homebound: The impact of caregiving, financial, and community resources on the lives of individuals with dementiaR01AG060967 · NIA · JOHNS HOPKINS UNIVERSITY · PI ORNSTEIN, KATHERINE A · 2019 to 2023
$2.5M
Fan Fox & Leslie R Samuels FoundationMedical Student in Aging Research (MSTAR) ProgramNIA NIH HHS NIA R01 AG060967NIA NIH HHS R01 AG060967
6 · The paper itself

Abstract

backgroundNovel hospital diversion strategies are needed to support a growing number of patients with dementia living in the community. One promising model is community paramedicine (CP), which deploys paramedics to the home, who consult with a physician to coordinate treatment and assess disposition. While evidence suggests CP can manage many patients without escalation to the emergency department (ED), no studies have evaluated optimal CP utilization for patients with dementia. Therefore, we compare the use and outcomes of CP for homebound patients with and without dementia.

methodsThis retrospective cohort study examines 251 homebound patients receiving home-based primary care, who utilized a physician-led CP service between March 2017 and May 2022. Linked electronic health record data included patient demographics, clinical characteristics, and CP encounter details. Dementia status and CP outcomes, including rates of ED transport, over-transport (i.e., transported, but not hospitalized), and under-transport (i.e., not transported, but ED visit within 3 days), were determined via chart review. Using logistic regression, we modeled the association of dementia status with over- and under-transport, adjusting for age, sex, and chief complaint.

resultsFifty-three percent of CP patients had dementia. Their most common chief complaints were dyspnea (24.3%), altered mental status (17.9%), and generalized weakness (9.8%). We found no significant difference in ED transport rates by dementia status (25.4 vs. 22.8%, p = 0.54). Dementia diagnosis was associated with lower rates of over-transport (OR = 0.21, p = 0.03, CI [0.05, 0.85]) and comparable rates of under-transport (OR = 0.70, p = 0.47, CI [0.27, 1.83]) in adjusted models.

conclusionsCP has effectively managed a diverse population of homebound patients with dementia cared for via home-based primary care. Future work should examine potential cost savings and use of CP in dementia care across geographic and healthcare settings.

Indexed as

DementiaParamedicineAgedAged, 80 and overEmergency Service, HospitalFemaleHomebound PersonsHome Care ServicesHumansMalePrimary Health CareRetrospective Studiescommunity paramedicinedementiahome‐based primary carehomeboundhospital diversion

Identifiers

PMID38485282
PMCPMC11226359
OpenAlexW4393022927

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.