title: Avoiding admissions from the ambulance service: a review of elderly patients with falls and patients with breathing difficulties seen by emergency care practitioners in South Yorkshire.
abstract: OBJECTIVE
  To determine the true impact of emergency care practitioners (ECPs) on admissions relative to emergency department (ED) attendance.
  
  
  METHODS
  Two groups of patients ringing 999 were studied: those classified as having breathing difficulties and elderly patients (>65 years) with a fall. Routinely collected data by Yorkshire Ambulance Service were compared with a historical comparison group from the local ED. Initial contact comparison was undertaken along with statistical analysis of secondary care attendance 28 days after initial contact with the ECP service.
  
  
  RESULTS
  The ECPs showed decreased rates of admission to hospital in both groups at initial contact and at 28 days (p<0.001 for those with breathing difficulties, p<0.05 for elderly patients with a fall).
  
  
  CONCLUSIONS
  ECPs help to prevent attendances and admissions by delivery of clinical care and assessment at point of access to health care beyond that traditionally provided by UK ambulance services. This study was limited in scope owing to the difficulties in ensuring an accurate comparison group.
authors.affiliation: Yorkshire Ambulance Service NHS Trust (South), Fairfields, Moorgate Road, Rotherham S60 2BQ, UK. james.gray@yas.nhs.uk
authors.forename: J T
authors.initials: JT
authors.lastname: Gray
authors.forename: A
authors.initials: A
authors.lastname: Walker
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000552:Ambulances; D016009:Chi-Square Distribution; D004417:Dyspnea / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D010819:Physician's Role; D006113:United Kingdom