{
  "abstract": "Introduction\n\nThe study objective was to compare the effects of the Community Paramedicine at Clinic (CP@clinic) program versus usual care on building-level health service utilization during a 12-month trial period and 12 months post-trial.Methods\n\nThis study employed a longitudinal, repeated cross-sectional design within a cluster-randomized controlled trial (RCT). It involved 30 apartment buildings across five Ontario communities, housing low-income older adults. Buildings were paired and randomized to receive either the CP@clinic intervention or continuing with usual care. Data was derived from ICES-maintained administrative health databases, linked using unique identifiers. The sample included all residents aged 55 + in the study postal codes from the Ontario Health Insurance Plan (OHIP) Registered Persons Database (RPDB), excluding those aged 120+, ineligible for OHIP, and those with no health care encounters within 7 years. The primary health care utilization outcome was emergency department visits by ambulance and other outcomes included hospital admissions and primary care visits.Results\n\nCP@clinic buildings showed significantly lower hospital admission rates during both the 12-month RCT period (adjusted incidence rate ratio [aIRR]: 0.75 [0.61,0.91]) and the 12-month post-RCT period [aIRR: 0.82 (0.70,0.96)] compared to usual care buildings. Primary care visits were lower in CP@clinic buildings during the RCT (aIRR: 0.93 [0.88,0.99]) but higher in the post-RCT period (aIRR: 1.05 [1.00,1.10]). No significant differences were found in emergency department visits or the number of days admitted between groups in either period.Discussion\n\nCP@clinic was linked to a sustained reduction in hospital admissions and an increase in primary care visits beyond the RCT time period, reflecting a shift from reactive to preventive care among older adults residing in social housing. The lasting impact beyond the RCT period suggests that the CP@clinic Program can improve health system efficiency, primary care access, and reduce health inequities in vulnerable populations.Trial registration\n\nClinicalTrials.gov, Identifier: NCT02152891.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Family Medicine, McMaster University , , ,",
    "Department of Health Research Methods, Evidence, and Impact, McMaster University , , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gina Agarwal"
    },
    {
      "affs": [
        0
      ],
      "name": "Melissa Pirrie"
    },
    {
      "affs": [
        0
      ],
      "name": "Manasvi Sai Vanama"
    },
    {
      "affs": [
        1
      ],
      "name": "Zheng Jing Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "J. Michael Paterson"
    },
    {
      "affs": [
        1
      ],
      "name": "Lehana Thabane"
    },
    {
      "affs": [
        0
      ],
      "name": "Ricardo Angeles"
    },
    {
      "affs": [
        0
      ],
      "name": "Francine Marzanek"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cgtavq0kmq1nk.bib",
  "cited_by": 0,
  "doi": "10.3389/frhs.2026.1939050",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716780/?tool=EBI",
  "id": "cgtavq0kmq1nk",
  "issns": [
    "2813-0146"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13716780",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2711|Emergency and Acute Care Studies"
    ]
  ],
  "openalex": "W7222092327",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716780/pdf/?tool=EBI",
  "pmcid": "PMC13716780",
  "pmid": "42959155",
  "published": "2026-10-15",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/cgtavq0kmq1nk.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:37Z",
      "native_id": "PMC:PMC13716780",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13716780"
    },
    {
      "first_seen": "2026-11-01T00:20:52Z",
      "native_id": "MED:42959155",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42959155"
    },
    {
      "first_seen": "2026-11-01T12:23:59Z",
      "native_id": "PMC13716780",
      "source": "pmc",
      "url": "https://doi.org/10.3389/frhs.2026.1939050"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2711|Emergency and Acute Care Studies",
      "subfield": "general"
    }
  ],
  "title": "Effect of the CP@clinic program (Community Paramedicine at Clinic program) on health care utilization from administrative data during and after the intervention: a cluster-randomized controlled trial",
  "title_text": "Effect of the CP@clinic program (Community Paramedicine at Clinic program) on health care utilization from administrative data during and after the intervention: a cluster-randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:13Z",
  "url": "https://research.draconitic.com/paper/cgtavq0kmq1nk",
  "venue": "Frontiers in health services",
  "versions": []
}