Barry Ashpole Media Watch #487

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific Region:

Specialist palliative services needed to reduce unnecessary hospitalisation near end of life

AUSTRALIA (Victoria) | Australian Ageing Agenda – 9 November 2016 – Almost one in 11 residents who died in their aged care facility were transferred to hospital and returned home in the week prior to their death, according to a Victorian-based study.1 The researchers found limited involvement in specialist palliative care (PC) services among this group and a potential lack of knowledge and skills in assessing residents and recognising signs of nearing end of life. The study … looked at the resident deaths of a large not-for-profit provider with 13 facilities and more than 800 beds, all of which had access to local specialist PC services, across metropolitan and regional Victoria from July 2014 to June 2105. Of the 252 deaths in that year, the vast majority occurred in the facility (86%). But 9% of these residents were transferred to hospital and returned home in the last week of their life. Nearly one-third of this group died within 24 hours of returning home and more than half died within two days. A quarter of these residents received PC services prior to going to hospital, a further 37% were referred to services by the hospital before going home and two residents transferred direct to hospice care, suggesting a need for improved access to services, the research found. The study identified opportunities to improve access to services through early referral or universal PC service access. https://goo.gl/xlC6Gs

Specialist Publications

What is the potential of community paramedicine to fill rural health care gaps?

JOURNAL OF HEALTH CARE FOR THE POOR & UNDERSERVED, 2016;27(4):144-158. Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and document review. Common goals included managing chronic disease (90.3%); and reducing emergency department visits (83.9%), hospital admissions/readmissions (83.9%), and costs (83.9%). Target populations included the chronically ill (90.3%), post-hospital discharge patients (80.6%), and frequent EMS users (64.5%). Community paramedicine programs engaged in bi-directional referrals most often with primary care facilities (67.7%), hospitals (54.8%), and home health (38.7%). Programs provided assessment, testing, preventive care, and post-discharge services. Reported outcomes were promising, but few programs used rigorous evaluation methods. Rural-serving CP programs provided services to shift costs to less expensive settings and provide appropriate care where vulnerable patients live, but more evidence is needed that care is safe, effective, and economical. https://goo.gl/UfYKRm