The core components of Community Paramedicine - integrated care in primary care setting: a scoping review

Scand J Caring Sci. 2019 Sep;33(3):508-521. doi: 10.1111/scs.12659. Epub 2019 Feb 8.

Abstract

Background: Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study.

Method: A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 - June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality.

Results: From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi-agency collaboration, (c) Patient-centred prevention and (d) Outcomes of programme: cost-effectiveness and patients' experiences.

Conclusion: The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.

Keywords: community paramedic; community paramedicine; emergency medical services; expanded scope of practice; prehospital care; primary health care; scoping review.

Publication types

  • Systematic Review

MeSH terms

  • Community Health Services / organization & administration*
  • Delivery of Health Care, Integrated / organization & administration*
  • Emergency Medical Services / organization & administration*
  • Humans
  • Primary Health Care / organization & administration*