A community health initiative in low-income areas may reduce hospital admission rates

1. In this longitudinal cross-sectional RCT, 30 low-income apartment buildings in Ontario received visits from the community paramedicine clinic, resulting in significantly lower hospital admission rates and an increase in primary care visits, placing an emphasis on preventive medicine.

Evidence Rating Level: 1 (Excellent)

Older adults and lower-income communities in Ontario often struggle to access primary care, resulting in increased visits to the ER, hospital admissions, and strain on emergency medical services. This study evaluates the implementation of the Community Paramedicine at Clinic Program, an evidence-based community health initiative that was implemented across five communities in Ontario, Canada. Within a 12-month study period, 30 subsidized seniors buildings were selected, where two specially trained paramedics would drop in for residents to conduct health risk assessments, provide tailored education, goal setting, and referrals to community services such as home care, wound care, or PSW support. Compared to usual care, the intervention group was associated with a 25% reduction in hospital admissions, with an adjusted incidence rate ratio (aIRR) of 0.75 (95% CI, 0.61-0.91) and an 18% reduction in hospital admissions after the study period ended (aIRR = 0.82, 95% CI, 0.70-0.96). There was no statistically significant difference in emergency department visits between the two groups, but residents within the intervention group had higher rates of primary care visits after the trial ended (aIRR=1.05, 95% CI, 1.00-1.10). Overall, this study shows the importance of emphasizing primary care and preventive health for older adults and low-income communities to reduce hospital visits and adverse health outcomes.

Click here to read this study in Frontiers in Health Services

Citation: Agarwal G, Pirrie M, Vanama MS, Hu ZJ, Paterson JM, Thabane L, et al. Effect of the CP@clinic program (Community Paramedicine at Clinic program) on health care utilization from administrative data during and after the intervention: a cluster-randomized controlled trial. Front Health Serv. 2026 Oct 15;6:1939050. doi: 10.3389/frhs.2026.1939050.

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