An Evaluation of Effectiveness

Contrary to the traditional role of the emergency room (ER) as a care source for the treatment of urgent medical needs, it is evident that substantial numbers of people now use the ER for the treatment of nonurgent problems In this paper, we report on public opinion about the role of the ER, the perceived urgency of the problems that people bring to the ER, the accessibility of medical care, and factors that prompt the use of the ER rather than other sources of care
The data result from a community survey of households (N = 521) in the area of Rochester, New York, representative of a population of about 580,000 people The findings, which relate ER utilization to source of payment, use of other sources of care, demographic variables, and consumer attitudes illustrate the rationality of the patient's use of ER facilities and reflect the patient's view of the ER as a place to obtain medical treatment when other sources are not available

A study of consumer attitudes about health care: the role of the emergency room.

Implementation of mobile intensive care units in four suburban communities permitted a retrospective evaluation of their impact on patient outcome. Data on 1,796 cases of myocardial infarction were obtained from medical records and death certificates of patients arriving at four hospitals during a 65-month period. There were statistically significant reductions in mortality rates in two communities (41.1% to 23.9% and 37.6% to 27.0%) after the service began. A reduction in one community (34.5% to 22.0%) was not statistically significant, and the fourth community showed an increase in the mortality rate (31.1% to 44.0%). Analysis of plausible rival hypotheses permitted most of these to be ruled out as causes for the observed reductions in mortality. ( JAMA 241:1899-1901, 1979)

Mobile intensive care units. An evaluation of effectiveness.

Two evaluation methods, one statistical and one comparative, were developed to assess the effectiveness of paramedic programs in King County, Washington. The outcome of hospital admission following prehospital cardiac arrest was used as a measure of effectiveness. In the statistical method, actual outcomes were compared with predicted outcomes. Predictive variables for admission were time from collapse to initiation of cardiopulmonary resuscitation and time from collapse to definitive care. Given knowledge of the predictive variables, the statistical evaluation enabled us to determine the probability of the outcome following cardiac arrest. In the comparative method, outcomes were compared with a standard in an adjacent community. Using this method, we identified program elements that could lead to improved outcome. Both evaluation methods are easily implemented.

https://www.annemergmed.com/article/S0361-1124(79)80060-X/pdf

Evaluation of paramedic programs using outcomes of prehospital resuscitation for cardiac arrest

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/pdf/evaluation-of-outcomes-for-cardiac-arrest-patients-treated-4peow5k9w3.pdf

Evaluation of outcomes for cardiac arrest patients treated by Provincial Ambulance Service personnel in the Lower Mainland of British Columbia

Emergency medical services: the research gaps.

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Emergency medical services: the research gaps.