Dr Denise Bunting1, Mr Alex Thompson1, Dr Emma Bosley1,2, Mr Adam Rolley1, Dr Steve Rashford1
1Queensland Ambulance Service, Brisbane, Australia, 2Queensland University of Technology, Brisbane, Australia
Complex and frequently presenting ambulance patients have a significantly increased rate of ambulance service use compared with the general patient population. Patients in this cohort are often treated episodically, but present with complicated clinical and social issues requiring coordinated management. Therefore, repeated emergency ambulance attendances do not provide appropriate, considered, or collaborative patient centred care.
Frequent presenters are disproportionally likely to be transported to hospital when compared to a demographically similar matched patient. This mismatch ultimately increases demand pressures on the prehospital and hospital emergency departments for patients who will ultimately be better served with robust connections to the primary and social care sectors.
In the previous financial year, 0.7% (3,771) of Queensland Ambulance Service (QAS) patients generated 8.8% (77,519) of the QAS annual calls for service, representing a significant response and fiscal burden on the QAS. Furthermore, 0.1% (424) of the identified Frequent Presenters, those with the highest utilisation rates, generated 2.7% (23,923) of QAS calls for service. Over 80% (62,288) of episodes of care resulted in subsequent ED attendance (not all are ambulance transports). This represented 3.3% of all public ED presentations.
The QAS Complex and Frequent Presenter initiative aims to involve specialist paramedics, pre-hospital doctors and support staff, along with hospital and community-based care providers, to identify, engage and enact patient centric care plans. The goal is to enable QAS frontline clinicians to deliver customised, coordinated and culturally appropriate management that best matches health system resources to the care needs of these individuals.
Biography:
Denise is the Clinical Research Coordinator (Statistics) at Queensland Ambulance Service (QAS) with over 17 years of experience in research, experimental design and statistical analysis. Her current research interests include the impact of ageing populations on emergency health, not transported ambulance patients, and complex and frequent presenters.