Prehospital pain treatment: an economic productivity factor in emergency medicine?
Rationale and objectives Analgesia is a recommended practice for pain treatment in prehospital emergency medicine, but all experts note suboptimal pain relief or oligoanalgesia. The increase in the Care Workload (CW) and the Medical Treatment Duration (MTD) linked to analgesia are two explanatory f...
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| Veröffentlicht in: | Journal of evaluation in clinical practice 2009-02, Vol.15 (1), p.152-157 |
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| creator | Hubert, Hervé Guinhouya, Comlavi Ricard-Hibon, Agnès Wiel, Eric Durocher, Alain Goldstein, Patrick |
| description | Rationale and objectives Analgesia is a recommended practice for pain treatment in prehospital emergency medicine, but all experts note suboptimal pain relief or oligoanalgesia. The increase in the Care Workload (CW) and the Medical Treatment Duration (MTD) linked to analgesia are two explanatory factors, and they are representative of the unavailability of a prehospital team. The unavailability of a team is an opportunity cost which is probably the most important cost within the framework of prehospital emergency. The aim of this study was to analyse the influence of analgesia use on the availability of prehospital emergency teams.
Methods This study was a prospective, multicentre cohort study conducted in 10 French Mobile Emergency and Resuscitation Services (MERS) between September 2001 and June 2003. A case–control study was performed including 568 case patients who received analgesia matched with controls based on diagnosis and severity. The pairs were compared for MTD and CW.
Results No significant difference between cases and controls was found concerning MTD (P = 0.134). Conversely, a difference was found for CW (P |
| doi_str_mv | 10.1111/j.1365-2753.2008.00973.x |
| format | Article |
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Methods This study was a prospective, multicentre cohort study conducted in 10 French Mobile Emergency and Resuscitation Services (MERS) between September 2001 and June 2003. A case–control study was performed including 568 case patients who received analgesia matched with controls based on diagnosis and severity. The pairs were compared for MTD and CW.
Results No significant difference between cases and controls was found concerning MTD (P = 0.134). Conversely, a difference was found for CW (P < 10−4), with a mean value of 53.7 Project Recherche Nursing (PRN) points for the cases and 45.8 PRN points for the controls.
Conclusions This study shows that analgesia generates an additional CW without increasing the MTD, and does not hinder the MERS teams' availability. This economic result should improve adherence to these clinical practice guidelines. Thus, analgesia appears to be a factor of productivity in the current context of economic pressures in terms of the funding of the healthcare system.</description><identifier>ISSN: 1356-1294</identifier><identifier>EISSN: 1365-2753</identifier><identifier>DOI: 10.1111/j.1365-2753.2008.00973.x</identifier><identifier>PMID: 19239596</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; analgesia ; Analgesia - utilization ; Case-Control Studies ; Cohort Studies ; economic assessment ; Emergency Medical Services - economics ; Female ; France ; Humans ; Male ; Middle Aged ; Pain - drug therapy ; Pain - nursing ; pain treatment ; Patient Care Team ; prehospital emergency ; productivity ; Prospective Studies</subject><ispartof>Journal of evaluation in clinical practice, 2009-02, Vol.15 (1), p.152-157</ispartof><rights>2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4043-ebaba11621dc4127c100312ca084fcc082db32836636ede8d7e944b35fa190a63</citedby><cites>FETCH-LOGICAL-c4043-ebaba11621dc4127c100312ca084fcc082db32836636ede8d7e944b35fa190a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2753.2008.00973.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2753.2008.00973.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19239596$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hubert, Hervé</creatorcontrib><creatorcontrib>Guinhouya, Comlavi</creatorcontrib><creatorcontrib>Ricard-Hibon, Agnès</creatorcontrib><creatorcontrib>Wiel, Eric</creatorcontrib><creatorcontrib>Durocher, Alain</creatorcontrib><creatorcontrib>Goldstein, Patrick</creatorcontrib><title>Prehospital pain treatment: an economic productivity factor in emergency medicine?</title><title>Journal of evaluation in clinical practice</title><addtitle>J Eval Clin Pract</addtitle><description>Rationale and objectives Analgesia is a recommended practice for pain treatment in prehospital emergency medicine, but all experts note suboptimal pain relief or oligoanalgesia. The increase in the Care Workload (CW) and the Medical Treatment Duration (MTD) linked to analgesia are two explanatory factors, and they are representative of the unavailability of a prehospital team. The unavailability of a team is an opportunity cost which is probably the most important cost within the framework of prehospital emergency. The aim of this study was to analyse the influence of analgesia use on the availability of prehospital emergency teams.
Methods This study was a prospective, multicentre cohort study conducted in 10 French Mobile Emergency and Resuscitation Services (MERS) between September 2001 and June 2003. A case–control study was performed including 568 case patients who received analgesia matched with controls based on diagnosis and severity. The pairs were compared for MTD and CW.
Results No significant difference between cases and controls was found concerning MTD (P = 0.134). Conversely, a difference was found for CW (P < 10−4), with a mean value of 53.7 Project Recherche Nursing (PRN) points for the cases and 45.8 PRN points for the controls.
Conclusions This study shows that analgesia generates an additional CW without increasing the MTD, and does not hinder the MERS teams' availability. This economic result should improve adherence to these clinical practice guidelines. Thus, analgesia appears to be a factor of productivity in the current context of economic pressures in terms of the funding of the healthcare system.</description><subject>Adult</subject><subject>Aged</subject><subject>analgesia</subject><subject>Analgesia - utilization</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>economic assessment</subject><subject>Emergency Medical Services - economics</subject><subject>Female</subject><subject>France</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain - drug therapy</subject><subject>Pain - nursing</subject><subject>pain treatment</subject><subject>Patient Care Team</subject><subject>prehospital emergency</subject><subject>productivity</subject><subject>Prospective Studies</subject><issn>1356-1294</issn><issn>1365-2753</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1v0zAUhi0Eot3gLyBf7S7BH4mTIKQJVaUblDEhEIgby3FOwF2-Zjus-fc4tOpu8Y2P5Od9bT8IYUpiGtbrXUy5SCOWpTxmhOQxIUXG4_0TtDwdPJ3nVESUFckCnTm3I4RykmbP0YIWjBdpIZboy62F370bjFcNHpTpsLegfAudf4NVh0H3Xd8ajQfbV6P25o_xE66V9r3FgYYW7C_o9IRbqIw2HVy-QM9q1Th4edzP0bf366-rq2j7eXO9ereNdEISHkGpSkWpYLTSCWWZpoRwyrQieVJrTXJWlZzlXAguoIK8yqBIkpKntaIFUYKfo4tDb3ja_QjOy9Y4DU2jOuhHJ4UoRKhPApgfQG175yzUcrCmVXaSlMjZp9zJWZuctcnZp_znU-5D9NXxjrEMH3wMHgUG4O0BeDANTP9dLD-sb8MQ4tEhbpyH_Smu7J0UGc9S-f1mI8XHHzdb_jOVn_hfHHGTcw</recordid><startdate>200902</startdate><enddate>200902</enddate><creator>Hubert, Hervé</creator><creator>Guinhouya, Comlavi</creator><creator>Ricard-Hibon, Agnès</creator><creator>Wiel, Eric</creator><creator>Durocher, Alain</creator><creator>Goldstein, Patrick</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200902</creationdate><title>Prehospital pain treatment: an economic productivity factor in emergency medicine?</title><author>Hubert, Hervé ; Guinhouya, Comlavi ; Ricard-Hibon, Agnès ; Wiel, Eric ; Durocher, Alain ; Goldstein, Patrick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4043-ebaba11621dc4127c100312ca084fcc082db32836636ede8d7e944b35fa190a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>analgesia</topic><topic>Analgesia - utilization</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>economic assessment</topic><topic>Emergency Medical Services - economics</topic><topic>Female</topic><topic>France</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain - drug therapy</topic><topic>Pain - nursing</topic><topic>pain treatment</topic><topic>Patient Care Team</topic><topic>prehospital emergency</topic><topic>productivity</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hubert, Hervé</creatorcontrib><creatorcontrib>Guinhouya, Comlavi</creatorcontrib><creatorcontrib>Ricard-Hibon, Agnès</creatorcontrib><creatorcontrib>Wiel, Eric</creatorcontrib><creatorcontrib>Durocher, Alain</creatorcontrib><creatorcontrib>Goldstein, Patrick</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of evaluation in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hubert, Hervé</au><au>Guinhouya, Comlavi</au><au>Ricard-Hibon, Agnès</au><au>Wiel, Eric</au><au>Durocher, Alain</au><au>Goldstein, Patrick</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prehospital pain treatment: an economic productivity factor in emergency medicine?</atitle><jtitle>Journal of evaluation in clinical practice</jtitle><addtitle>J Eval Clin Pract</addtitle><date>2009-02</date><risdate>2009</risdate><volume>15</volume><issue>1</issue><spage>152</spage><epage>157</epage><pages>152-157</pages><issn>1356-1294</issn><eissn>1365-2753</eissn><abstract>Rationale and objectives Analgesia is a recommended practice for pain treatment in prehospital emergency medicine, but all experts note suboptimal pain relief or oligoanalgesia. The increase in the Care Workload (CW) and the Medical Treatment Duration (MTD) linked to analgesia are two explanatory factors, and they are representative of the unavailability of a prehospital team. The unavailability of a team is an opportunity cost which is probably the most important cost within the framework of prehospital emergency. The aim of this study was to analyse the influence of analgesia use on the availability of prehospital emergency teams.
Methods This study was a prospective, multicentre cohort study conducted in 10 French Mobile Emergency and Resuscitation Services (MERS) between September 2001 and June 2003. A case–control study was performed including 568 case patients who received analgesia matched with controls based on diagnosis and severity. The pairs were compared for MTD and CW.
Results No significant difference between cases and controls was found concerning MTD (P = 0.134). Conversely, a difference was found for CW (P < 10−4), with a mean value of 53.7 Project Recherche Nursing (PRN) points for the cases and 45.8 PRN points for the controls.
Conclusions This study shows that analgesia generates an additional CW without increasing the MTD, and does not hinder the MERS teams' availability. This economic result should improve adherence to these clinical practice guidelines. Thus, analgesia appears to be a factor of productivity in the current context of economic pressures in terms of the funding of the healthcare system.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19239596</pmid><doi>10.1111/j.1365-2753.2008.00973.x</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged analgesia Analgesia - utilization Case-Control Studies Cohort Studies economic assessment Emergency Medical Services - economics Female France Humans Male Middle Aged Pain - drug therapy Pain - nursing pain treatment Patient Care Team prehospital emergency productivity Prospective Studies |
| title | Prehospital pain treatment: an economic productivity factor in emergency medicine? |
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