Paramedic drop-ins keep local seniors healthy

McMaster study shows low-cost program can reduce ambulance calls

A McMaster University study shows that a low-cost enterprise by paramedics can significantly reduce emergency ambulance calls and improve the health of seniors living in Hamilton’s social housing apartment buildings.

The study looked at the effectiveness of weekly drop-in health assessment clinics operated by members of the Hamilton Paramedic Service.

The researchers identified a number of CityHousing Hamilton buildings with high proportions of seniors in similar parts of the city and then matched up the buildings into two groups.

Half of the buildings received the program, which involved paramedics providing health assessments at dropin clinics in the building once a week for a year.

The other half of the buildings did not receive the program.

Participation in the program was voluntary for residents, who received blood pressure readings, a health-risk assessment and a discussion on how to mitigate those risks.

A year later, the researchers compared what happened to ambulance calls before and after the program in both sets of buildings.

They found the number of emergency ambulance calls dropped by about one call per month for every 100 apartment units in the buildings that received the program compared to those

that didn’t get the program.

The paramedic program also discovered significant numbers of people with undiagnosed high blood pressure, along with cases of people experiencing elevated blood pressure who had already been diagnosed with hypertension.

“In an average 200-unit building — and there are many buildings of that size in Hamilton — that would mean this program could reduce 911 calls by 22 per cent in one of those buildings, which would translate to about 25 calls less per year,” said Dr. Gina Agarwal, the study’s lead author.

“That doesn’t sound like much but it’s actually quite a lot,” added Agarwal, a family physician and researcher in McMaster’s Department of Family Medicine.

At a roughly estimated $1,000 cost per ambulance call, the program could save $25,000 a year in ambulance calls for a standard City-Housing Hamilton building geared to seniors.

“I’m actually quite amazed how remarkable the results are for such a low-cost simple program like this,” Agarwal said. “The results have very far-reaching implications.”

Agarwal also noted that the participation rates for those buildings in the program ranged from about 20 per cent to 50 per cent. If participation rates could be improved, she said, the reduction in ambulance calls could be even greater.

The results of the study are being published Monday in the Canadian Medical Association Journal.

Agarwal said her team used data from The Spectator’s landmark Code Red project to identify potential apartment buildings.

Like Agarwal’s study, Code Red examined the effects of the social determinants of health and the connections between poverty and poor health.

Most of the buildings targeted for the study were in the downtown core, with some on the Mountain.

While the reduction in ambulance calls was important, Agarwal said, so too was the general improvement in residents’ health from the assessments and blood pressure readings.

“I think it’s remarkable that a simple program like this could do all that,” she said.

An accompanying CMAJ commentary states “the study by Agarwal and colleagues shows that patients with chronic conditions can benefit from improved access to health-care resources and services in a familiar setting through the establishment of trusting relationships with local providers of paramedic services.”

“The trial further highlights the potential value of deploying a low-cost community paramedicine intervention in a high-risk social-housing setting,” wrote Michael Nolan of the County of Renfrew.

Agarwal is now testing a sister project that will assess the effectiveness of a paramedic program designed to provide structured home visits to people who frequently rely on 911 calls.