Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada

Objective Paramedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics on responding to a 911/999 medical emergency after an assessment of the presenting condition. Ambulatory care sensitive conditions (ACSCs) are non-acute hea...

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Main Authors: Kamlesh Khunti, Robert Spaight, Niro Siriwardena, Gina Agarwal, Graham Law, Melissa Pirrie, Ricardo Angeles, Mark Gussy, Brent McLeod, Aloysius Niroshan Siriwardena, Gregory Whitley, Bartholomew Hill, Richard Ferron, Harriet Moore, Gregory Adam Whitley, Iwona Bielska, Jasdeep Brar, Rhiannon Cooper
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e073520.full
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author Kamlesh Khunti
Robert Spaight
Niro Siriwardena
Gina Agarwal
Graham Law
Melissa Pirrie
Ricardo Angeles
Mark Gussy
Brent McLeod
Aloysius Niroshan Siriwardena
Gregory Whitley
Bartholomew Hill
Richard Ferron
Harriet Moore
Gregory Adam Whitley
Iwona Bielska
Jasdeep Brar
Rhiannon Cooper
author_facet Kamlesh Khunti
Robert Spaight
Niro Siriwardena
Gina Agarwal
Graham Law
Melissa Pirrie
Ricardo Angeles
Mark Gussy
Brent McLeod
Aloysius Niroshan Siriwardena
Gregory Whitley
Bartholomew Hill
Richard Ferron
Harriet Moore
Gregory Adam Whitley
Iwona Bielska
Jasdeep Brar
Rhiannon Cooper
collection DOAJ
description Objective Paramedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics on responding to a 911/999 medical emergency after an assessment of the presenting condition. Ambulatory care sensitive conditions (ACSCs) are non-acute health conditions not needing hospital admission when properly managed. This study aimed to map the paramedic impression codes to ACSCs and mental health conditions for use in future research on avoidable 911/999 calls.Design Mapping paramedic impression codes to existing definitions of ACSCs and mental health conditions.Setting East Midlands Region, UK and Southern Ontario, Canada.Participants Expert panel from the UK-Canada Emergency Calls Data analysis and GEospatial mapping (EDGE) Consortium.Results Mapping was iterative first identifying the common ACSCs shared between the two countries then identifying the respective clinical impression codes for each country that mapped to those shared ACSCs as well as to mental health conditions. Experts from the UK-Canada EDGE Consortium contributed to both phases and were able to independently match the codes and then compare results. Clinical impression codes for paramedics in the UK were more extensive than those in Ontario. The mapping revealed some interesting inconsistencies between paramedic impression codes but also demonstrated that it was possible.Conclusion This is an important first step in determining the number of ASCSs and mental health conditions that paramedics attend to, and in examining the clinical pathways of these individuals across the health system. This work lays the foundation for international comparative health services research on integrated pathways in primary care and emergency medical services.
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spelling doaj-art-2a81611076c246d5bf0451dd686b985a2025-08-20T02:10:46ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-073520Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada 0Kamlesh Khunti1Robert Spaight2Niro SiriwardenaGina Agarwal3Graham LawMelissa Pirrie4Ricardo Angeles5Mark Gussy6Brent McLeod7Aloysius Niroshan Siriwardena8Gregory WhitleyBartholomew HillRichard Ferron9Harriet Moore10Gregory Adam Whitley11Iwona BielskaJasdeep Brar12Rhiannon CooperSPRinG Network, Severn and Peninsula Deaneries, UKDiabetes Research Centre, University of Leicester, Leicester, UKEast Midlands Ambulance Service NHS Trust, Lincoln, UKDepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaUniversity of Lincoln, Lincoln, UKHamilton Paramedic Service, Hamilton, Ontario, CanadaLincoln School of Health and Social Care, University of Lincoln, Lincoln, UKNiagara Emergency Medical Services, Niagara, Ontario, CanadaUniversity of Lincoln, Lincoln, UKCommunity and Health Research Unit, University of Lincoln, Lincoln, UKDepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaObjective Paramedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics on responding to a 911/999 medical emergency after an assessment of the presenting condition. Ambulatory care sensitive conditions (ACSCs) are non-acute health conditions not needing hospital admission when properly managed. This study aimed to map the paramedic impression codes to ACSCs and mental health conditions for use in future research on avoidable 911/999 calls.Design Mapping paramedic impression codes to existing definitions of ACSCs and mental health conditions.Setting East Midlands Region, UK and Southern Ontario, Canada.Participants Expert panel from the UK-Canada Emergency Calls Data analysis and GEospatial mapping (EDGE) Consortium.Results Mapping was iterative first identifying the common ACSCs shared between the two countries then identifying the respective clinical impression codes for each country that mapped to those shared ACSCs as well as to mental health conditions. Experts from the UK-Canada EDGE Consortium contributed to both phases and were able to independently match the codes and then compare results. Clinical impression codes for paramedics in the UK were more extensive than those in Ontario. The mapping revealed some interesting inconsistencies between paramedic impression codes but also demonstrated that it was possible.Conclusion This is an important first step in determining the number of ASCSs and mental health conditions that paramedics attend to, and in examining the clinical pathways of these individuals across the health system. This work lays the foundation for international comparative health services research on integrated pathways in primary care and emergency medical services.https://bmjopen.bmj.com/content/13/12/e073520.full
spellingShingle Kamlesh Khunti
Robert Spaight
Niro Siriwardena
Gina Agarwal
Graham Law
Melissa Pirrie
Ricardo Angeles
Mark Gussy
Brent McLeod
Aloysius Niroshan Siriwardena
Gregory Whitley
Bartholomew Hill
Richard Ferron
Harriet Moore
Gregory Adam Whitley
Iwona Bielska
Jasdeep Brar
Rhiannon Cooper
Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
BMJ Open
title Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
title_full Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
title_fullStr Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
title_full_unstemmed Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
title_short Development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
title_sort development of indicators for avoidable emergency medical service calls by mapping paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the uk and canada
url https://bmjopen.bmj.com/content/13/12/e073520.full
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