Evidence map›Paper›PMID 39083199›Full record

ArticleCJEM2024

Economic evaluation of the "paramedics and palliative care: bringing vital services to Canadians" program compared to the status quo.

J E Tarride, D Stennett, A C Coronado, R Shaw Moxam, J H E Yong, A J E Carter, C Cameron, F Xie, M Grignon, H Seow and 2 more

Abstract readComparative Study
In one paragraph

Article in CJEM, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

J E TarrideCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada. tarride@mcmaster.ca.
D StennettHealthcare Excellence Canada, Ottawa, ON, Canada.
A C CoronadoCanadian Partnership Against Cancer, Toronto, ON, Canada.
R Shaw MoxamCanadian Partnership Against Cancer, Toronto, ON, Canada.
J H E YongCanadian Partnership Against Cancer, Toronto, ON, Canada.
A J E CarterDepartment of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.
C CameronCanadian Virtual Hospice, Winnipeg, MB, Canada.
F XieCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.
M GrignonCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.
H SeowCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.
G BlackhouseCentre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-7157-6344
Paramedics and Palliative Care: Bringing Vital Services to Canadians Paramedic Partners

Funding

Canadian Partnership against Cancer 12625Healthcare Excellence Canada 12625
6 · The paper itself

Abstract

objectiveBased on programs implemented in 2011-2013 in three Canadian provinces to improve the support paramedics provide to people receiving palliative care, the Canadian Partnership Against Cancer and Healthcare Excellence Canada provided support and funding from 2018 to 2022 to spread this approach in Canada. The study objectives were to conduct an economic evaluation of "the Program" compared to the status quo.

methodsA probabilistic decision analytic model was used to compare the expected costs, the quality-adjusted life years (QALYs) and the return on investment associated with the Program compared to the status quo from a publicly funded healthcare payer perspective. Effectiveness data and Program costs, expressed in 2022 Canadian dollars, from each jurisdiction were supplemented with literature data. Probabilistic sensitivity analyses varying key model assumptions were conducted.

resultsAnalyses of 5416 9-1-1 calls from five jurisdictions where paramedics provided support to people with palliative care needs between April 1, 2020 and March 31, 2022 indicated that 60% of the 9-1-1 calls under the Program enabled people to avoid transport to the emergency department and receive palliative care at home. Treating people at home saved paramedics an average of 31 min (range from 15 to 67). The Program was associated with cost savings of $2773 (95% confidence interval [CI] $1539-$4352) and an additional 0.00069 QALYs (95% CI 0.00024-0.00137) per 9-1-1 palliative care call. The Program return on investment was $4.6 for every $1 invested. Threshold analyses indicated that in order to be cost saving, 33% of 9-1-1 calls should be treated at home under the Program, the Program should generate a minimum of 97 calls per year with each call costing no more than $2773.

conclusionThe Program was cost-effective in the majority of the scenarios examined. These results support the implementation of paramedic-based palliative care at home programs in Canada.

Indexed as

Cost-Benefit AnalysisPalliative CareAllied Health PersonnelCanadaEmergency Medical ServicesHumansNorth American PeopleParamedicsProgram EvaluationQuality-Adjusted Life YearsCost-effectivenessEconomicsPalliativeParamedic

Identifiers

PMID39083199
PMCPMC11377656

What OpenQuestion holds

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Registered trials

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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.