Community Paramedic Home Care Program for Acute Decompensated Heart Failure: A Pilot Study

Community paramedic (CP) mobile integrated healthcare program (MIHP) home visits for acute decompensated heart failure (HF) may ease care transitions, reduce costs, and prevent emergency department visits. 1,2Still, CP-MIHP HF programs have observed 30-day readmission rates as high as 30% to 40% in end-stage (stage D) HF, with frequent non-HF-related admissions attributed to frailty and comorbidities. 1,2This reflects the HF disease trajectory, where hospitalizations are frequent in advanced stages. 3As such, home time, defined as time alive and out of healthcare facilities, has emerged as an important patient-centric outcome, highly correlated with mortality and hospitalization. 4Postdischarge home time at 30 days or 1 year has been proposed as an end point to evaluate HF interventions. 4 The Mayo Clinic HF Team and CPs collaborated in a pilot of CP-MIHP for decompensated HF requiring intermediate acuity care to increase home time.