Abbeville Community Paramedicine Program To Prevent Frequent ED Use

Introduction: Abbeville, in rural South Carolina, is serviced by a critical access hospital. Abbeville residents have higher rates of chronic disease, which has led to high rates of emergency department (ED) use. Abbeville County Emergency Management Services (ACEMS) began the Community Paramedicine (CP) Program to utilize paramedics to improve care of frequent ED users at least one of the following diagnoses: Hypertension (HTN), Diabetes (DM), Chronic Heart Failure (CHF), Asthma, and Chronic Obstructive Pulmonary Disease (COPD).

Findings: Of the 59 patients enrolled into the program, 46 patients were uninsured at the time of enrollment. 22 uninsured patients were referred to Medicaid, Medicare, or disability benefits. Other uninsured patients were given a medical home at a free clinic. 34 patients are now seeing a PCP on a regular basis.

            Following 4 months of enrollment into the program, we found a 64% decrease in ER usage. Inpatient stays fell by 71%, with the average length of stay falling from 2.6 days to 1.0 day among those with a stay. We also found significant differences in the disease-specific quality measures. As a group, 84% of patients diagnosed with hypertension saw a decrease in their blood pressure readings, while 78.7% of diabetic patients had a significantly lower average blood glucose level.

Conclusions: At the current time, the CP program has shown the ability to make a significant difference in the health of patients, and a reduction in their health care utilization. Future analyses regarding sustainability and funding models of the CP program are planned.