Context
Ireland’s population is growing and aging. Significant increases in health-service utilisation are occurring. In parallel, major issues with workforce recruitment and retention are emerging. Similar trends are apparent internationally. The coalescence of these issues is resulting in immediate and long-term challenges in planning and delivering health-services. Internationally, health-systems are responding by innovating in service delivery and attempting to ‘shift-left’ i.e., treating more patients in primary care and in the community. Ireland’s ‘Slaintecare’ high level health-policy attempts to reorientate the health-system towards efficient, integrated primary and community care.
Unscheduled care is healthcare which cannot reasonably be foreseen in advance of contact, and thus must be available 24/7. Ireland’s population of five million people generates approximately three million episodes of unscheduled care each year. This project will focus on the component of unscheduled care that is delivered in the community by General Practice and Ambulance services. Previous research has demonstrated that the availability and nature of this type of care is important to patients, and can modify costly, hospital-based care down-stream.
Aim and Impacts
To generate a data-driven, theoretically-informed, co-designed, framework for the evaluation of novel integrated GP and Paramedic unscheduled care over the next decade.
Methods
A concurrent, mixed-methods, health service research project. We will conduct in-depth qualitative research to understand unscheduled care innovation, reform and evaluation across exemplar international contexts. We will harness available Irish socio-demographic, health-service structure, and GP/ Paramedic service utilisation data, then employ multi-level statistical mixed-modeling approaches to model future demand and simulate the impact of novel interventions. We will conduct in-depth qualitative research to understand stakeholder priorities, and local drivers of unscheduled care utilisation for common health problems. We will integrate findings using a triangulation protocol approach and lever this data to support the co-design of an evaluation framework for complex Paramedic-GP integrated care interventions.