Using paramedics to identify at-risk elderly.
OBJECTIVE
To evaluate paramedics' ability to identify elderly at risk and refer them for assessment and service.


METHODS
A prospective nonrandomized open trial.


METHODS
Akron, Ohio, a midsize city with a well-developed advanced life support emergency medical services system.


METHODS
One hundred thirty firefighter paramedics evaluated 6,000 elderly patients. Assessments were performed by trained geriatric assessors.


METHODS
Regardless of the reason for the call, paramedics screened all emergency medical services users age 60 and older for medical, mental health, social, and environmental problems. Identified cases were referred to the Area Agency on Aging for assessment and follow-up.


RESULTS
Paramedics identified 197 people with possible problems, 124 of whom received an assessment. The remainder could not be assessed due to death, moving, referral, or transfer to a long-term care facility. Assessors confirmed the presence of a problem in 121 of 124 assessed cases, a positive predictive value of 98%. The program was useful for 94 people, 48% of those identified and assessed.


CONCLUSIONS
Paramedics can serve as case finders for at-risk elderly, and effective linkage to service agencies can occur.
Gerson
L W
LW
Department of Epidemiology, Northeastern Ohio Universities College of Medicine, Rootstown.
Schelble
D T
DT
Wilson
J E
JE
D000368:Aged; D004634:Emergency Medical Technicians; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009820:Ohio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011996:Records; D012307:Risk Factors