This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
A trip to the emergency room, or ER, worries most people, but it can be even more stressful for people with long-term health problems or physical and mental health disabilities. Patients may worry that they will not get the care they need from ER staff who don’t know them and their health problems or disabilities.
Patients sometimes call 911 for problems that are safe to treat in non-urgent care settings. In other countries, giving paramedics more ability to treat non-emergency patients has reduced trips to the hospital without harming patients. The acute community care program, or ACCP, is a new program in greater Boston, Massachusetts. Specially-trained paramedics carry medical equipment and supplies and travel to patients’ homes. They can access patients’ medical records and talk with their doctors. When possible, they can treat patients on-site rather than taking them to the ER.
The research team is studying whether ACCP helps people with urgent health problems avoid trips to the ER. ACCP serves adults who have ongoing health problems or have physical or mental health disabilities.
Who can this research help?
Healthcare organizations can look at findings from this study as they consider ways to improve urgent care for people with long-term health problems or disabilities.
What is the research team doing?
The research team is working with an ACCP in Massachusetts that serves adults who have both Medicare and Medicaid coverage. The team is comparing 200 patients who receive care from ACCP with 700 patients who visit ERs for urgent care.
About a week after patients receive care from ACCP or at an ER, the research team is interviewing patients and giving them a survey about their care experiences. The survey asks patients about their treatment and about whether clinicians such as doctors or nurses treated them respectfully. Each patient may also select a family member, friend, or caregiver who was present at the visit to fill out a survey and speak with the research team about the experience.
The research team is also interviewing paramedics about their job experiences and career satisfaction. In addition, the team is looking at the resources, equipment, time, and staff needed for ACCP.
Patients and paramedics are working with the research team to plan and conduct the study.