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PP57 Indicators for avoidable emergency medical service calls: mapping of paramedic clinical impression codes to ambulatory care sensitive conditions and mental health conditions in the UK and Canada
  1. Gina Agarwal1,
  2. A Niroshan Siriwardena2,
  3. Brent McLeod3,
  4. Robert Spaight4,
  5. Gregory Whitley4,
  6. Richard Ferron5,
  7. Melissa Pirrie1,
  8. Ricardo Angeles1,
  9. Harriet Moore1,
  10. Mark Gussey2,
  11. on behalf of the EDGE Consortium
  1. 1McMaster University, Hamilton, Canada
  2. 2University of Lincoln, UK
  3. 3Hamilton Paramedic Service, Hamilton, Canada
  4. 4East Midlands Ambulance Service NHS Trust, Nottingham, UK
  5. 5Niagara Emergency Medical Services, Niagara-on-the-Lake, Canada


Background Paramedic assessment data have not been used for research on avoidable calls. Paramedic impression codes are designated by paramedics upon 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.

Methods The current study focused on paramedic impression codes from the East Midlands Region, UK and from Southern Ontario, Canada and mapped them to existing definitions of ambulatory care sensitive conditions (ACSCs) and mental health conditions. 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.

Results Experts from the UK-Canada Emergency Calls Data analysis and GEospatial mapping (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 numbers 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 EMS.

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