Early experiences with the Acute Community Care Program in eastern Massachusetts

Area of Science:

• Healthcare delivery innovation
• Urgent care services
• Community health programs

Background:

• Emergency departments (EDs) often manage nonemergent conditions outside standard office hours.
• A program was developed to provide after-hours urgent care in patients' homes using paramedics.

Purpose of the Study:

• To report the operational results of the Acute Community Care Program (ACCP) over its first two years.
• To assess the feasibility and preliminary outcomes of in-home urgent care delivery.

Main Methods:

• Observational study utilizing descriptive methods.
• Analysis of administrative claims, financial records, service logs, and patient perception surveys.
• Data collected from a health insurer and ambulance service provider partnership.

Main Results:

• ACCP saw increased utilization from 1 to 2 visits daily over two years.
• 15-20% of patients were transported to EDs; 7.2-17.1% were hospitalized within 1 day.
• Patient satisfaction was high (90%+ willing to receive future care), and costs decreased significantly.

Conclusions:

• The ACCP demonstrates potential as an alternative to EDs for after-hours urgent care.
• Preliminary evidence suggests a viable model for community-based urgent care.
• More rigorous evaluation is necessary to confirm ACCP's effectiveness and impact.