Outcomes and provider perspectives on geriatric care by a nurse practitioner-led community paramedicine program.

Only 35 patients from one geriatric clinic were studied, so the results cannot be applied broadly. There was no comparison group, so it is impossible to know what would have happened if patients had called the clinic or gone to the emergency department. The service included a nurse practitioner or physician assistant, an EMT, and on-call ED physician support, so the contribution of any one component cannot be separated. Visit notes were missing for 18% of visits and late for 7.5%, so the clinic may not have seen important acute findings in time. Patients and caregivers were not interviewed, so their own experiences are unknown. The study did not test whether the service reduced avoidable ED visits or hospitalizations.

The authors reported no financial interests or formal clinical partnership with DispatchHealth. The paper is marked as NIH extramural research support.

Do not read the two immediate transfers among 40 visits as proof that this service prevents ED visits or hospitalizations. It was a 35-patient case series without a comparison group, and the service included a nurse practitioner or physician assistant, an EMT, and on-call ED physician support, so the contribution of any one component cannot be separated.