Community Paramedicine: An integrated care model in a Primary health care setting

Tuija Rasku

Research output: Book/ReportDoctoral thesisCollection of Articles

Abstract

The aim of this study was to explore the core components of Community Paramedicine (CP), how CP is implemented in Finland, and the factors associated with the Finnish Community nurse-paramedics’ (CNP) decision-making when patient remained at home or needed transportation to the hospital. Additionally, the aim was to describe the CNPs’ experiences of the novel sphere of practice in primary health care setting. Finally, the findings of the three sub-studies were adapted to the Rainbow Model of Integrated Care (RMIC) as a parent model.

The mixed methods were used to collect data in four phases. Data were collected through a scoping review, a retrospective review of patient charts, an ethnographic observation, and semi-structured interviews with Finnish CNPs in three hospital- districts (HD). Inductive data analysis methods and statistical analyses including multivariable logistic regression were used.

According to the results, the core components of CP were community engagement, multi-agency collaboration, patient-centred prevention, and outcomes of programme: cost-effectiveness and patients’ experiences. With the CNPs’ decisions of the patient’s care continuum associated five independent factors: the hospital district, if the patient could walk, the nature of the task, whether the troponin test was performed, and physician was consulted. The CNP needs a new way of thinking, has a broad group of patients, the broad way to provide care, the diversity of multidisciplinary collaboration, and tailored support from the organisation.

This study demonstrates the adaptation of CP model as integrated care model with macro-, meso- and micro-levels of Rainbow model of integrated care. The results can be used by organisations, educators, health care professionals and policy planners accountable for driving more integrated services in local health care system through the design and implementation of CP.

CP can provide the needed help for the overgrounded health care and offer proactive patient assessment there where it is best to find the holistic view for the patient care continuum – at home. Further studies are needed to explore the CP patients’ and allied health team members’ views and experiences about CP. The integrated CP model created in this study is to be tested and developed further in primary care settings.
Original languageEnglish
Place of PublicationTampere
ISBN (Electronic)978-952-03-2286-1
Publication statusPublished - 2022
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume549
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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