Paramedic attendance to older patients in Australia, and the prevalence and implications of psychosocial issues

Objective: This study aims to determine the number and reasons for emergency paramedic attendances to older adults in Victoria, Australia. A second aim is to investigate the prevalence of psychosocial factors that may contribute to older patients requiring emergency paramedic attendance. Methods: This descriptive retrospective study analyzed all emergency paramedic attendances to patients aged 65 or older between July 1, 2011 and June 30, 2014 in Victoria, Australia. Fully de-identified data were extracted from the Ambulance Victoria Data Warehouse. Data included demographic and clinical variables such as age, gender, case nature (cause), past history, management and transportation, paramedic final assessment (diagnosis), social situation, past history; as well as free text case descriptions. Results: A total of 596,579 patients 65 years or older were attended by emergency paramedics during the study period. This accounted for 24.1% of Ambulance Victoria workload during that period. The mean (SD) age of patients was 79.8(8.2). The majority (70.7%) of cases involved patients at private residences. The most common final assessments were pain (18.7%), cardiac problem (7.2%), infection (6.9%), trauma (6.7%), other/unknown (6.4%), and respiratory problem (5.7%). The vast majority of patients were transported to hospital (82.8%). Psychosocial issues were evident in the free text case descriptions of more than 91,000 cases. Conclusion: Paramedics attended almost 600,000 patients 65 years and older during the study period. Patients suffered from conditions including, pain, trauma, infections, cardiac complaints, and respiratory problems. Free text case descriptions provided more detail and insight into the reasons for emergency paramedic attendance. Psychosocial problems were far more prevalent than indicated by the “final assessment” field. Further research is required to determine the reasons and implications of this.