Excellence in Value Demonstration or Research: This award recognizes an EMS or non-EMS organization that created and implemented an analysis of data and/or research project to demonstrate the value impact of the services provided by the organization.

Description

This nomination is to recognize the authors of an article that was published in the Journal of the American Medical Association (JAMA), a peer-reviewed medical journal published 48 times a year by the American Medical Association. The study in question was published on February 24, 2021.

IMPORTANCE - Mobile Integrated Health (MIH) is a model of community-based health care to provide on-site urgent or nonurgent care. Niagara Emergency Medical Services (NEMS) started implementing MIH in 2018 to serve the Niagara Region of Ontario, Canada. However, it's economic impact was unknown.

OBJECTIVE - To compare time on task and cost between MIH and ambulance service delivered by NEMS from a public payer’s perspective.

RESEARCH QUESTION - Is MIH delivered by Niagara EMS more efficient than regular ambulance responses in addressing the needs of urgent care in the community?

KEY FINDINGS - This economic evaluation compared 1740 calls serviced by MIH in 2018 to 2019 with propensity score-matched ambulance calls for the same period and 2 years prior and found that MIH was associated with a decrease in the proportion of patients transported to the emergency department and saved health care costs compared with regular ambulance responses.

MEANING - These findings suggest that MIH is a promising and viable solution to meeting urgent health care needs while improving the efficiency in using emergency care resources.

CONCLUSIONS AND RELEVANCE - Compared with regular ambulance response, MIH was associated with a substantial reduction in the proportion of patients transported to the ED, leading to a substantial saving in total costs. This finding suggests that the MIH model is a promising and viable solution to meeting urgent health care needs in the community, while substantially improving the use of scarce health care resources.

Author Overview
McMaster University - Hamilton, Ontario, Canada

(Feng Xie, PhD - lead author of research study, and Jiajun Yan, MSc1; Gina Agarwal, MBBS, PhD1,3; et al contributing authors)

Feng Xie is a Professor of Health Economics in the Department of Health Research Methods, Evidence and Impact (HEI) and a member of the Centre for Health Economics and Policy Analysis. His research interests include health technology assessment, economic evaluations using models and trial data, patient-reported outcome and preference measures, and health utility measures.

Description of Data & Methodology

This economic evaluation of MIH was an analysis of administrative databases without contact with any patient or individual.  The information for all emergency calls received and responded to from 2016 to 2019 was retrieved from the NEMS database, which records the location and priority description of the call, age and sex of the patient, the description of the response vehicle, whether transport to ED was required, and service times. Cost data were retrieved from the NEMS accounting database, including all equipment costs, operating costs, and salary and benefits of all staff employed.

Study results have been shared publicly via open access article that was published in the Journal of the American Medical Association on February 24, 2021.  It has also been spotlighted with local media interviews in the Niagara Region, and shared by email with local, national and international EMS stakeholders.

Supporting Links
Link to journal article on JAMA website:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776751

Newspaper article on results of research study: "Researchers determine Niagara EMS program reduces costs by 66%" https://www.stcatharinesstandard.ca/news/niagara-region/2021/02/25/researchers-determine-niagara-ems-program-reduces-costs-by-66.html

Xie et All 2021 MIH Economic Evaluation.pdf: http://aimhi.mobi/resources/Awards/2021%20Awards/Xie%20et%20All%202021%20MIH%20Economic%20Evaluation.pdf