Division of Trauma, Department of Orthopaedics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio, USA.
J Am Geriatr Soc. 2024 Feb;72(2):512-519. doi: 10.1111/jgs.18687. Epub 2023 Nov 17.
Millions of older US adults fall annually, leading to catastrophic injuries, over 32,000 deaths and healthcare costs of over $55 billion. This study evaluated perceived benefits and limitations of using community paramedicine for fall prevention strategies from the lens of older adults, caregivers, and healthcare providers.
Semi-structured focus groups were held with individuals from three stakeholder groups: (1) community-dwelling older adults (age ≥60), (2) caregivers, and (3) healthcare providers. The Strengths-Weaknesses-Opportunities-Threats (SWOT) framework was used to quantitatively analyze stakeholder perceptions of using community paramedicine for fall prevention strategies.
A total of 10 focus groups were held with 56 participants representing older adults (n = 15), caregivers (n = 16), and healthcare providers (n = 25). Community paramedicine was supported as a model of fall prevention by older adults, caregivers, and healthcare providers. Participants identified strengths such as visibility to the home environment, ability to implement home modifications, implicit trust in emergency medical services (EMS), and capacity to redirect resources toward prevention. Additionally, participants acknowledged opportunities such as providing continuity of care across the healthcare spectrum, improving quality and safety of care and potentially reducing unnecessary emergency department use. Participants endorsed weaknesses and threats such as funding, concerns of patients about stigma, and struggles with medical data integration.
The results of this study illuminate the opportunity to leverage community paramedicine to address a variety of perceived barriers in order to design and implement better solutions for fall prevention efforts.
每年有数百万美国老年人跌倒，导致灾难性伤害，超过 32000 人死亡，医疗保健费用超过 550 亿美元。本研究从老年人、护理人员和医疗保健提供者的角度评估了使用社区护理人员进行跌倒预防策略的感知益处和局限性。
对来自三个利益相关者群体的个体进行了半结构式焦点小组讨论：（1）居住在社区的老年人（年龄≥60 岁），（2）护理人员，（3）医疗保健提供者。使用优势-劣势-机会-威胁（SWOT）框架对利益相关者对使用社区护理人员进行跌倒预防策略的看法进行了定量分析。
共进行了 10 次焦点小组讨论，共有 56 名参与者代表老年人（n=15）、护理人员（n=16）和医疗保健提供者（n=25）。老年人、护理人员和医疗保健提供者均支持将社区护理人员作为跌倒预防模式。参与者确定了一些优势，例如对家庭环境的可见性、实施家庭改造的能力、对紧急医疗服务（EMS）的隐含信任，以及将资源重新用于预防的能力。此外，参与者还认识到一些机会，例如提供医疗保健范围内的连续性护理、提高护理质量和安全性，并有可能减少不必要的急诊室使用。参与者认可了一些劣势和威胁，例如资金、患者对污名的担忧，以及医疗数据整合的困难。
这项研究的结果阐明了利用社区护理人员来解决各种感知障碍的机会，以便为跌倒预防工作设计和实施更好的解决方案。
