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Background <p>Community paramedicine service (CPS) may improve prehospital healthcare delivery in rural regions. As CPS does not provide patient transport, its introduction could prolong prehospital time intervals. Thus, we aimed to evaluate whether CPS implementation influenced prehospital time intervals for acute patients admitted to hospital.</p> Methods <p>In this quasi-experimental study, we compared prehospital time intervals for acute missions resulting in hospital admission in two rural Norwegian municipalities with similar characteristics. Data were collected over four years before and two years after CPS implementation in one municipality (CPS<sub>REGION</sub>). The second municipality served as a control (CONTROL<sub>REGION</sub>).</p> Results <p>Of 1,872 missions, 362 acute missions with hospital admission were included, of which 228 occurred in the CPS<sub>REGION</sub> and 134 in the CONTROL<sub>REGION</sub>. After CPS implementation, the median response interval was reduced from 19 to 11&#xa0;min (<i>p</i> &lt; 0.001), whereas no statistically significant changes were observed for the other prehospital time intervals in the CPS<sub>REGION</sub> or for any prehospital time intervals in the CONTROL<sub>REGION</sub> (all <i>p</i> &gt; 0.12). Difference-in-differences analyses showed no statistically significant difference for total prehospital interval (-2&#xa0;min, <i>p</i> = 0.850), while there were significantly shorter response- (-7&#xa0;min, <i>p</i> &lt; 0.001) and emergency medical service (EMS) on-scene intervals (-6&#xa0;min, <i>p</i> = 0.003). Higher age was associated with longer total prehospital interval (<i>p</i> = 0.018).</p> Conclusions <p>CPS implementation was not associated with changes of the total prehospital interval but was linked to shorter response interval and EMS on-scene intervals, which may indicate earlier arrival of prehospital personnel without evidence of delayed start of transport. However, given the observational design and the absence of clinical outcome data, the overall impact on patient safety and system performance remains uncertain.</p>

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The impact of community paramedicine service on prehospital time intervals in rural Norway: a quasi-experimental study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Odd Eirik Elden,
  • Oddvar Uleberg,
  • Emma Brulin,
  • Bodil J. Landstad,
  • Maja Pålsdatter Lønvik,
  • Øyvind Salvesen,
  • Havard Dalen

摘要

Background

Community paramedicine service (CPS) may improve prehospital healthcare delivery in rural regions. As CPS does not provide patient transport, its introduction could prolong prehospital time intervals. Thus, we aimed to evaluate whether CPS implementation influenced prehospital time intervals for acute patients admitted to hospital.

Methods

In this quasi-experimental study, we compared prehospital time intervals for acute missions resulting in hospital admission in two rural Norwegian municipalities with similar characteristics. Data were collected over four years before and two years after CPS implementation in one municipality (CPSREGION). The second municipality served as a control (CONTROLREGION).

Results

Of 1,872 missions, 362 acute missions with hospital admission were included, of which 228 occurred in the CPSREGION and 134 in the CONTROLREGION. After CPS implementation, the median response interval was reduced from 19 to 11 min (p < 0.001), whereas no statistically significant changes were observed for the other prehospital time intervals in the CPSREGION or for any prehospital time intervals in the CONTROLREGION (all p > 0.12). Difference-in-differences analyses showed no statistically significant difference for total prehospital interval (-2 min, p = 0.850), while there were significantly shorter response- (-7 min, p < 0.001) and emergency medical service (EMS) on-scene intervals (-6 min, p = 0.003). Higher age was associated with longer total prehospital interval (p = 0.018).

Conclusions

CPS implementation was not associated with changes of the total prehospital interval but was linked to shorter response interval and EMS on-scene intervals, which may indicate earlier arrival of prehospital personnel without evidence of delayed start of transport. However, given the observational design and the absence of clinical outcome data, the overall impact on patient safety and system performance remains uncertain.