SPRAINED-refs.bib

@misc{r_core_team_r:_2019,
	address = {Vienna, Austria},
	title = {R: {A} {Language} and {Environment} for {Statistical} {Computing}},
	shorttitle = {https://www.{R}-project.org},
	publisher = {R Foundation for Statistical Computing},
	author = {{R Core Team}},
	year = {2019}
}

@article{penfold_use_2013,
	series = {Quality {Improvement} in {Pediatric} {Health} {Care}},
	title = {Use of {Interrupted} {Time} {Series} {Analysis} in {Evaluating} {Health} {Care} {Quality} {Improvements}},
	volume = {13},
	issn = {1876-2859},
	url = {http://www.sciencedirect.com/science/article/pii/S1876285913002106},
	doi = {10.1016/j.acap.2013.08.002},
	abstract = {Interrupted time series (ITS) analysis is arguably the strongest quasi-experimental research design. ITS is particularly useful when a randomized trial is infeasible or unethical. The approach usually involves constructing a time series of population-level rates for a particular quality improvement focus (eg, rates of attention-deficit/hyperactivity disorder [ADHD] medication initiation) and testing statistically for a change in the outcome rate in the time periods before and time periods after implementation of a policy/program designed to change the outcome. In parallel, investigators often analyze rates of negative outcomes that might be (unintentionally) affected by the policy/program. We discuss why ITS is a useful tool for quality improvement. Strengths of ITS include the ability to control for secular trends in the data (unlike a 2-period before-and-after t test), ability to evaluate outcomes using population-level data, clear graphical presentation of results, ease of conducting stratified analyses, and ability to evaluate both intended and unintended consequences of interventions. Limitations of ITS include the need for a minimum of 8 time periods before and 8 after an intervention to evaluate changes statistically, difficulty in analyzing the independent impact of separate components of a program that are implemented close together in time, and existence of a suitable control population. Investigators must also be careful not to make individual-level inferences when population-level rates are used to evaluate interventions (though ITS can be used with individual-level data). A brief description of ITS is provided, including a fully implemented (but hypothetical) study of the impact of a program to reduce ADHD medication initiation in children younger than 5 years old and insured by Medicaid in Washington State. An example of the database needed to conduct an ITS is provided, as well as SAS code to implement a difference-in-differences model using preschool-age children in California as a comparison group.},
	number = {6, Supplement},
	urldate = {2019-08-14},
	journal = {Academic Pediatrics},
	author = {Penfold, Robert B. and Zhang, Fang},
	month = nov,
	year = {2013},
	keywords = {quality improvement, interrupted time series, quasi-experimental, research design},
	pages = {S38--S44},
	file = {ScienceDirect Full Text PDF:/Users/tricky999/Zotero/storage/9W8W2A48/Penfold and Zhang - 2013 - Use of Interrupted Time Series Analysis in Evaluat.pdf:application/pdf;ScienceDirect Snapshot:/Users/tricky999/Zotero/storage/VPPUQESX/S1876285913002106.html:text/html}
}

@article{lopez_bernal_methodological_2018,
	title = {A methodological framework for model selection in interrupted time series studies},
	volume = {103},
	issn = {08954356},
	url = {https://linkinghub.elsevier.com/retrieve/pii/S0895435617314117},
	doi = {10.1016/j.jclinepi.2018.05.026},
	abstract = {Interrupted time series is a powerful and increasingly popular design for evaluating public health and health service interventions. The design involves analysing trends in the outcome of interest and estimating the change in trend following an intervention relative to the counterfactual (the expected ongoing trend if the intervention had not occurred). There are two key components to modelling this effect: first, defining the counterfactual; second, defining the type of effect that the intervention is expected to have on the outcome, known as the impact model. The counterfactual is defined by extrapolating the underlying trends observed before the intervention to the post-intervention period. In doing this, authors must consider the pre-intervention period that will be included, any time varying confounders, whether trends may vary within different subgroups of the population and whether trends are linear or non-linear. Defining the impact model involves specifying the parameters that model the intervention, including for instance whether to allow for an abrupt level change or a gradual slope change, whether to allow for a lag before any effect on the outcome, whether to allow a transition period during which the intervention is being implemented and whether a ceiling or floor effect might be expected. Inappropriate model specification can bias the results of an interrupted time series analysis and using a model that is not closely tailored to the intervention or testing multiple models increases the risk of false positives being detected. It is important that authors use substantive knowledge to customise their interrupted time series model a priori to the intervention and outcome under study. Where there is uncertainty in model specification, authors should consider using separate data sources to define the intervention, running limited sensitivity analyses or undertaking initial exploratory studies.},
	language = {en},
	urldate = {2019-08-12},
	journal = {Journal of Clinical Epidemiology},
	author = {Lopez Bernal, J. and Soumerai, S. and Gasparrini, A.},
	month = nov,
	year = {2018},
	pages = {82--91},
	file = {Lopez Bernal et al. - 2018 - A methodological framework for model selection in .pdf:/Users/tricky999/Zotero/storage/RJU6LUVY/Lopez Bernal et al. - 2018 - A methodological framework for model selection in .pdf:application/pdf}
}

@misc{curtis_unit_2018,
	type = {Monograph},
	title = {Unit {Costs} of {Health} and {Social} {Care} 2018},
	url = {https://www.pssru.ac.uk/project-pages/unit-costs/},
	language = {en},
	urldate = {2019-11-28},
	author = {Curtis, Lesley A. and Burns, Amanda},
	year = {2018},
	doi = {Curtis, Lesley A. and Burns, Amanda  (2018)   Unit Costs of Health and Social Care 2018.     Project report. University of Kent  10.22024/UniKent/01.02.70995 <https://doi.org/10.22024/UniKent%2F01.02.70995>.      (doi:10.22024/UniKent/01.02.70995 <https://doi.org/10.22024/UniKent%2F01.02.70995>)},
	file = {Full Text PDF:/Users/tricky999/Zotero/storage/6HN7SL4X/Curtis and Burns - 2018 - Unit Costs of Health and Social Care 2018.pdf:application/pdf;Snapshot:/Users/tricky999/Zotero/storage/WNPS6KQX/70995.html:text/html}
}

@misc{health_education_england_agenda_2019,
	title = {Agenda for change - pay rates},
	url = {https://www.healthcareers.nhs.uk/working-health/working-nhs/nhs-pay-and-benefits/agenda-change-pay-rates},
	abstract = {Band 1 (Please note that following the 2018 pay deal, band 1 closed to new entrants from 1 December 2018).  {\textless} 1 year experience  £17,6521+ years                    £17,652},
	language = {en},
	urldate = {2019-11-28},
	journal = {Health Careers},
	author = {{Health Education England}},
	year = {2019},
	file = {Snapshot:/Users/tricky999/Zotero/storage/PYYA63WI/agenda-change-pay-rates.html:text/html}
}

@misc{nhs_improvement_reference_2018,
	title = {Reference {Costs}},
	url = {https://improvement.nhs.uk/resources/reference-costs/},
	urldate = {2019-11-28},
	author = {{NHS Improvement}},
	year = {2018},
	file = {Reference costs | NHS Improvement:/Users/tricky999/Zotero/storage/95VVZYY9/reference-costs.html:text/html}
}

@article{ocathain_understanding_2018,
	title = {Understanding variation in ambulance service non-conveyance rates: a mixed methods study},
	volume = {6},
	issn = {2050-4349, 2050-4357},
	shorttitle = {Understanding variation in ambulance service non-conveyance rates},
	url = {https://www.journalslibrary.nihr.ac.uk/hsdr/hsdr06190},
	doi = {10.3310/hsdr06190},
	abstract = {Background
              In England in 2015/16, ambulance services responded to nearly 11 million calls. Ambulance Quality Indicators show that half of the patients receiving a response by telephone or face to face were not conveyed to an emergency department. A total of 11\% of patients received telephone advice only. A total of 38\% of patients were sent an ambulance but were not conveyed to an emergency department. For the 10 large ambulance services in England, rates of calls ending in telephone advice varied between 5\% and 17\%. Rates of patients who were sent an ambulance but not conveyed to an emergency department varied between 23\% and 51\%. Overall non-conveyance rates varied between 40\% and 68\%.
            
            
              Objective
              To explain variation in non-conveyance rates between ambulance services.
            
            
              Design
              A sequential mixed methods study with five work packages.
            
            
              Setting
              Ten of the 11 ambulance services serving {\textgreater} 99\% of the population of England.
            
            
              Methods
              (1) A qualitative interview study of managers and paramedics from each ambulance service, as well as ambulance commissioners (totalling 49 interviews undertaken in 2015). (2) An analysis of 1 month of routine data from each ambulance service (November 2014). (3) A qualitative study in three ambulance services with different published rates of calls ending in telephone advice (120 hours of observation and 20 interviews undertaken in 2016). (4) An analysis of routine data from one ambulance service linked to emergency department attendance, hospital admission and mortality data (6 months of 2013). (5) A substudy of non-conveyance for people calling 999 with breathing problems.
            
            
              Results
              Interviewees in the qualitative study identified factors that they perceived to affect non-conveyance rates. Where possible, these perceptions were tested using routine data. Some variation in non-conveyance rates between ambulance services was likely to be due to differences in the way rates were calculated by individual services, particularly in relation to telephone advice. Rates for the number of patients sent an ambulance but not conveyed to an emergency department were associated with patient-level factors: age, sex, deprivation, time of call, reason for call, urgency level and skill level of attending crew. However, variation between ambulance services remained after adjustment for patient-level factors. Variation was explained by ambulance service-level factors after adjustment for patient-level factors: the percentage of calls attended by advanced paramedics [odds ratio 1.05, 95\% confidence interval (CI) 1.04 to 1.07], the perception of ambulance service staff and commissioners that advanced paramedics were established and valued within the workforce of an ambulance service (odds ratio 1.84, 95\% CI 1.45 to 2.33), and the perception of ambulance service staff and commissioners that senior management was risk averse regarding non-conveyance within an ambulance service (odds ratio 0.78, 95\% CI 0.63 to 0.98).
            
            
              Limitations
              Routine data from ambulance services are complex and not consistently collected or analysed by ambulance services, thus limiting the utility of comparative analyses.
            
            
              Conclusions
              Variation in non-conveyance rates between ambulance services in England could be reduced by addressing variation in the types of paramedics attending calls, variation in how advanced paramedics are used and variation in perceptions of the risk associated with non-conveyance within ambulance service management. Linking routine ambulance data with emergency department attendance, hospital admission and mortality data for all ambulance services in the UK would allow comparison of the safety and appropriateness of their different non-conveyance rates.
            
            
              Funding
              The National Institute for Health Research Health Services and Delivery Research programme.},
	language = {en},
	number = {19},
	urldate = {2019-11-28},
	journal = {Health Services and Delivery Research},
	author = {O’Cathain, Alicia and Knowles, Emma and Bishop-Edwards, Lindsey and Coster, Joanne and Crum, Annabel and Jacques, Richard and James, Cathryn and Lawson, Rod and Marsh, Maggie and O’Hara, Rachel and Siriwardena, Aloysius Niroshan and Stone, Tony and Turner, Janette and Williams, Julia},
	month = may,
	year = {2018},
	pages = {1--192},
	file = {O’Cathain et al. - 2018 - Understanding variation in ambulance service non-c.pdf:/Users/tricky999/Zotero/storage/QHQPXRRB/O’Cathain et al. - 2018 - Understanding variation in ambulance service non-c.pdf:application/pdf}
}

@misc{turner_evaluation_2018,
	title = {An {Evaluation} of early stage development of rotating paramedic model pilot sites},
	url = {https://www.hee.nhs.uk/sites/default/files/documents/Feasability%20Study%20of%20the%20Rotating%20Paramedics%20Pilot%20-%20Final.pdf},
	language = {en},
	urldate = {2019-10-10},
	author = {Turner, Janette and Williams, Julia},
	year = {2018},
	file = {Turner and Williams - An Evaluation of early stage development of rotati.pdf:/Users/tricky999/Zotero/storage/YEQV6FEE/Turner and Williams - An Evaluation of early stage development of rotati.pdf:application/pdf}
}

@article{mason_developing_2003,
	title = {Developing a community paramedic practitioner intermediate care support scheme for older people with minor conditions},
	volume = {20},
	issn = {14720205, 14720213},
	url = {http://emj.bmj.com/cgi/doi/10.1136/emj.20.2.196},
	doi = {10.1136/emj.20.2.196},
	language = {en},
	number = {2},
	urldate = {2019-10-22},
	journal = {Emergency Medicine Journal},
	author = {Mason, S},
	month = mar,
	year = {2003},
	pages = {196--198},
	file = {Mason - 2003 - Developing a community paramedic practitioner inte.pdf:/Users/tricky999/Zotero/storage/M2ZK3LWH/Mason - 2003 - Developing a community paramedic practitioner inte.pdf:application/pdf}
}

@article{sun_effect_2013,
	title = {Effect of {Emergency} {Department} {Crowding} on {Outcomes} of {Admitted} {Patients}},
	volume = {61},
	issn = {0196-0644},
	url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690784/},
	doi = {10.1016/j.annemergmed.2012.10.026},
	abstract = {Study objective
Emergency department (ED) crowding is a prevalent health delivery problem and may adversely affect the outcomes of patients requiring admission. We assess the association of ED crowding with subsequent outcomes in a general population of hospitalized patients.

Methods
We performed a retrospective cohort analysis of patients admitted in 2007 through the EDs of nonfederal, acute care hospitals in California. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay and costs. ED crowding was established by the proxy measure of ambulance diversion hours on the day of admission. To control for hospital-level confounders of ambulance diversion, we defined periods of high ED crowding as those days within the top quartile of diversion hours for a specific facility. Hierarchic regression models controlled for demographics, time variables, patient comorbidities, primary diagnosis, and hospital fixed effects. We used bootstrap sampling to estimate excess outcomes attributable to ED crowding.

Results
We studied 995,379 ED visits resulting in admission to 187 hospitals. Patients who were admitted on days with high ED crowding experienced 5\% greater odds of inpatient death (95\% confidence interval [CI] 2\% to 8\%), 0.8\% longer hospital length of stay (95\% CI 0.5\% to 1\%), and 1\% increased costs per admission (95\% CI 0.7\% to 2\%). Excess outcomes attributable to periods of high ED crowding included 300 inpatient deaths (95\% CI 200 to 500 inpatient deaths), 6,200 hospital days (95\% CI 2,800 to 8,900 hospital days), and \$17 million (95\% CI \$11 to \$23 million) in costs.

Conclusion
Periods of high ED crowding were associated with increased inpatient mortality and modest increases in length of stay and costs for admitted patients.},
	number = {6},
	urldate = {2019-10-22},
	journal = {Annals of emergency medicine},
	author = {Sun, Benjamin C. and Hsia, Renee Y. and Weiss, Robert E. and Zingmond, David and Liang, Li-Jung and Han, Weijuan and McCreath, Heather and Asch, Steven M.},
	month = jun,
	year = {2013},
	pmid = {23218508},
	pmcid = {PMC3690784},
	pages = {605--611.e6},
	file = {PubMed Central Full Text PDF:/Users/tricky999/Zotero/storage/GH326YNZ/Sun et al. - 2013 - Effect of Emergency Department Crowding on Outcome.pdf:application/pdf}
}

@article{richardson_increase_2006,
	title = {Increase in patient mortality at 10 days associated with emergency department overcrowding},
	volume = {184},
	issn = {0025-729X},
	abstract = {OBJECTIVE: To quantify any relationship between emergency department (ED) overcrowding and 10-day patient mortality.
DESIGN AND SETTING: Retrospective stratified cohort analysis of three 48-week periods in a tertiary mixed ED in 2002-2004. Mean "occupancy" (a measure of overcrowding based on number of patients receiving treatment) was calculated for 8-hour shifts and for 12-week periods. The shifts of each type in the highest quartile of occupancy were classified as overcrowded.
PARTICIPANTS: All presentations of patients (except those arriving by interstate ambulance) during "overcrowded" (OC) shifts and during an equivalent number of "not overcrowded" (NOC) shifts (same shift, weekday and period).
MAIN OUTCOME MEASURE: In-hospital death of a patient recorded within 10 days of the most recent ED presentation.
RESULTS: There were 34 377 OC and 32 231 NOC presentations (736 shifts each); the presenting patients were well matched for age and sex. Mean occupancy was 21.6 on OC shifts and 16.4 on NOC shifts. There were 144 deaths in the OC cohort and 101 in the NOC cohort (0.42\% and 0.31\%, respectively; P=0.025). The relative risk of death at 10 days was 1.34 (95\% CI, 1.04-1.72). Subgroup analysis showed that, in the OC cohort, there were more presentations in more urgent triage categories, decreased treatment performance by standard measures, and a higher mortality rate by triage category.
CONCLUSIONS: In this hospital, presentation during high ED occupancy was associated with increased in-hospital mortality at 10 days, after controlling for seasonal, shift, and day of the week effects. The magnitude of the effect is about 13 deaths per year. Further studies are warranted.},
	language = {eng},
	number = {5},
	journal = {The Medical Journal of Australia},
	author = {Richardson, Drew B.},
	month = mar,
	year = {2006},
	pmid = {16515430},
	keywords = {Female, Humans, Male, Middle Aged, Adolescent, Age Factors, Child, Cohort Studies, Child, Preschool, Aged, Retrospective Studies, Adult, Aged, 80 and over, Infant, Emergency Service, Hospital, Infant, Newborn, Time Factors, Triage, Hospital Mortality, Patient Admission, Crowding, Australian Capital Territory, Bed Occupancy},
	pages = {213--216}
}

@article{guttmann_association_2011,
	title = {Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from {Ontario}, {Canada}},
	volume = {342},
	copyright = {© Guttmann et al 2011. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/  and  http://creativecommons.org/licenses/by-nc/2.0/legalcode.},
	issn = {0959-8138, 1468-5833},
	shorttitle = {Association between waiting times and short term mortality and hospital admission after departure from emergency department},
	url = {https://www.bmj.com/content/342/bmj.d2983},
	doi = {10.1136/bmj.d2983},
	abstract = {Objective To determine whether patients who are not admitted to hospital after attending an emergency department during shifts with long waiting times are at risk for adverse events.
Design Population based retrospective cohort study using health administrative databases.
Setting High volume emergency departments in Ontario, Canada, fiscal years 2003-7.
Participants All emergency department patients who were not admitted (seen and discharged; left without being seen).
Outcome measures Risk of adverse events (admission to hospital or death within seven days) adjusted for important characteristics of patients, shift, and hospital.
Results 13 934 542 patients were seen and discharged and 617 011 left without being seen. The risk of adverse events increased with the mean length of stay of similar patients in the same shift in the emergency department. For mean length of stay ≥6 v {\textless}1 hour the adjusted odds ratio (95\% confidence interval) was 1.79 (1.24 to 2.59) for death and 1.95 (1.79 to 2.13) for admission in high acuity patients and 1.71 (1.25 to 2.35) for death and 1.66 (1.56 to 1.76) for admission in low acuity patients). Leaving without being seen was not associated with an increase in adverse events at the level of the patient or by annual rates of the hospital.
Conclusions Presenting to an emergency department during shifts with longer waiting times, reflected in longer mean length of stay, is associated with a greater risk in the short term of death and admission to hospital in patients who are well enough to leave the department. Patients who leave without being seen are not at higher risk of short term adverse events.},
	language = {en},
	urldate = {2019-10-22},
	journal = {BMJ},
	author = {Guttmann, Astrid and Schull, Michael J. and Vermeulen, Marian J. and Stukel, Therese A.},
	month = jun,
	year = {2011},
	pmid = {21632665},
	pages = {d2983},
	file = {Full Text PDF:/Users/tricky999/Zotero/storage/54HWXNK6/Guttmann et al. - 2011 - Association between waiting times and short term m.pdf:application/pdf;Snapshot:/Users/tricky999/Zotero/storage/RH877BK9/bmj.html:text/html}
}

@article{bernstein_effect_2009,
	title = {The {Effect} of {Emergency} {Department} {Crowding} on {Clinically} {Oriented} {Outcomes}},
	volume = {16},
	copyright = {© 2008 by the Society for Academic Emergency Medicine},
	issn = {1553-2712},
	url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1553-2712.2008.00295.x},
	doi = {10.1111/j.1553-2712.2008.00295.x},
	abstract = {Background: An Institute of Medicine (IOM) report defines six domains of quality of care: safety, patient-centeredness, timeliness, efficiency, effectiveness, and equity. The effect of emergency department (ED) crowding on these domains of quality has not been comprehensively evaluated. Objectives: The objective was to review the medical literature addressing the effects of ED crowding on clinically oriented outcomes (COOs). Methods: We reviewed the English-language literature for the years 1989–2007 for case series, cohort studies, and clinical trials addressing crowding’s effects on COOs. Keywords searched included “ED crowding,”“ED overcrowding,”“mortality,”“time to treatment,”“patient satisfaction,”“quality of care,” and others. Results: A total of 369 articles were identified, of which 41 were kept for inclusion. Study quality was modest; most articles reflected observational work performed at a single institution. There were no randomized controlled trials. ED crowding is associated with an increased risk of in-hospital mortality, longer times to treatment for patients with pneumonia or acute pain, and a higher probability of leaving the ED against medical advice or without being seen. Crowding is not associated with delays in reperfusion for patients with ST-elevation myocardial infarction. Insufficient data were available to draw conclusions on crowding’s effects on patient satisfaction and other quality endpoints. Conclusions: A growing body of data suggests that ED crowding is associated both with objective clinical endpoints, such as mortality, as well as clinically important processes of care, such as time to treatment for patients with time-sensitive conditions such as pneumonia. At least two domains of quality of care, safety and timeliness, are compromised by ED crowding.},
	language = {en},
	number = {1},
	urldate = {2019-10-22},
	journal = {Academic Emergency Medicine},
	author = {Bernstein, Steven L. and Aronsky, Dominik and Duseja, Reena and Epstein, Stephen and Handel, Dan and Hwang, Ula and McCarthy, Melissa and McConnell, K. John and Pines, Jesse M. and Rathlev, Niels and Schafermeyer, Robert and Zwemer, Frank and Schull, Michael and Asplin, Brent R.},
	year = {2009},
	keywords = {quality of care, patient safety, emergency department crowding},
	pages = {1--10},
	file = {Full Text PDF:/Users/tricky999/Zotero/storage/SJYMLV3U/Bernstein et al. - 2009 - The Effect of Emergency Department Crowding on Cli.pdf:application/pdf;Snapshot:/Users/tricky999/Zotero/storage/NPWR78SP/j.1553-2712.2008.00295.html:text/html}
}

@misc{willett_addressing_2017,
	title = {Addressing ambulance handover delays},
	url = {https://www.england.nhs.uk/wp-content/uploads/2017/11/ambulance-handover-letter.pdf},
	urldate = {2019-10-10},
	author = {Willett, Keith and Benger, Jonathan},
	year = {2017}
}

@misc{nhs_england_ambulance_2019,
	title = {Ambulance {Quality} {Indicators} {Data} 2018-19},
	url = {https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/ambulance-quality-indicators-data-2018-19/},
	urldate = {2019-10-22},
	author = {{NHS England}},
	year = {2019},
	file = {Statistics » Ambulance Quality Indicators Data 2018-19:/Users/tricky999/Zotero/storage/7DACBG65/ambulance-quality-indicators-data-2018-19.html:text/html}
}

@misc{national_audit_office_nhs_2017,
	title = {{NHS} {Ambulance} {Services}},
	url = {https://www.nao.org.uk/report/nhs-ambulance-services/},
	abstract = {Ambulance services are finding it increasingly difficult to cope with rising demand for urgent and emergency services, according to the NAO},
	language = {en-US},
	urldate = {2019-10-22},
	journal = {National Audit Office},
	author = {{National Audit Office}},
	year = {2017},
	file = {Snapshot:/Users/tricky999/Zotero/storage/CNQ5IMZF/nhs-ambulance-services.html:text/html}
}

@article{sekhon_multivariate_2011,
	title = {Multivariate and {Propensity} {Score} {Matching} {Software} with {Automated} {Balance} {Optimization}: {The} {Matching} package for {R}},
	volume = {42},
	copyright = {Copyright (c) 2007 Jasjeet S. Sekhon},
	issn = {1548-7660},
	shorttitle = {Multivariate and {Propensity} {Score} {Matching} {Software} with {Automated} {Balance} {Optimization}},
	url = {https://www.jstatsoft.org/index.php/jss/article/view/v042i07},
	doi = {10.18637/jss.v042.i07},
	language = {en},
	number = {1},
	urldate = {2020-05-27},
	journal = {Journal of Statistical Software},
	author = {Sekhon, Jasjeet S.},
	month = jun,
	year = {2011},
	note = {Number: 1},
	pages = {1--52},
	file = {Full Text:/Users/tricky999/Zotero/storage/L9U9DR2E/Sekhon - 2011 - Multivariate and Propensity Score Matching Softwar.pdf:application/pdf;Snapshot:/Users/tricky999/Zotero/storage/I6A5MWZI/v042i07.html:text/html}
}

@book{mitchell_introduction_1996,
	address = {Cambridge, Mass},
	series = {Complex adaptive systems},
	title = {An introduction to genetic algorithms},
	isbn = {978-0-262-13316-6},
	publisher = {MIT Press},
	author = {Mitchell, Melanie},
	year = {1996},
	keywords = {Genetics, Computer simulation, Mathematical models},
	annote = {"A Bradford book"},
	file = {Melanie - An Introduction to Genetic Algorithms.pdf:/Users/tricky999/Zotero/storage/WB9DH8YH/Melanie - An Introduction to Genetic Algorithms.pdf:application/pdf}
}

@article{wagner_segmented_2002,
	title = {Segmented regression analysis of interrupted time series studies in medication use research},
	volume = {27},
	issn = {0269-4727, 1365-2710},
	url = {http://doi.wiley.com/10.1046/j.1365-2710.2002.00430.x},
	doi = {10.1046/j.1365-2710.2002.00430.x},
	abstract = {Interrupted time series design is the strongest, quasi-experimental approach for evaluating longitudinal effects of interventions. Segmented regression analysis is a powerful statistical method for estimating intervention effects in interrupted time series studies. In this paper, we show how segmented regression analysis can be used to evaluate policy and educational interventions intended to improve the quality of medication use and ⁄ or contain costs.},
	language = {en},
	number = {4},
	urldate = {2020-05-27},
	journal = {Journal of Clinical Pharmacy and Therapeutics},
	author = {Wagner, A. K. and Soumerai, S. B. and Zhang, F. and Ross-Degnan, D.},
	month = aug,
	year = {2002},
	pages = {299--309},
	file = {Wagner et al. - 2002 - Segmented regression analysis of interrupted time .pdf:/Users/tricky999/Zotero/storage/FDYHYHUD/Wagner et al. - 2002 - Segmented regression analysis of interrupted time .pdf:application/pdf}
}

@article{hodge_maintaining_2018,
	title = {Maintaining competency: a qualitative study of clinical supervision and mentorship as a framework for specialist paramedics},
	volume = {3},
	issn = {1478-4726},
	shorttitle = {Maintaining competency},
	url = {https://www.ingentaconnect.com/content/10.29045/14784726.2018.12.3.3.10},
	doi = {10.29045/14784726.2018.12.3.3.10},
	abstract = {Introduction: The aim of this study was to explore the factors influencing the maintenance of clinical competence and the effectiveness of the specialist paramedic in the context of mentorship, from the specialist paramedic’s own perspective.
Methods: Semi-structured interviews were conducted with eight specialist paramedics in four regions of one ambulance service. Thematic analysis and coding were used to explore the data and identify emergent themes.
Results: The study identified three key themes: appropriate clinical exposure; support and development; and opportunity for reflection. A tailored clinical leadership and mentorship model is required to maintain competency and effectiveness of specialist paramedics. Participants valued a model that delivered support, development and role clarity. Experienced advanced practitioners as mentors and organisational commitment were highlighted as essential components.
Conclusions: Mentorship is an essential training requirement in extended roles to maximise efficacy of complex care out of hospital, to maintain clinical competence and as a source of motivation and psychological support.},
	language = {en},
	number = {3},
	urldate = {2020-05-29},
	journal = {British Paramedic Journal},
	author = {Hodge, Andrew and Swift, Samuel and Wilson, John P.},
	month = dec,
	year = {2018},
	pages = {10--15},
	file = {Hodge et al. - 2018 - Maintaining competency a qualitative study of cli.pdf:/Users/tricky999/Zotero/storage/B7XTHJEA/Hodge et al. - 2018 - Maintaining competency a qualitative study of cli.pdf:application/pdf}
}

@article{eaton_contribution_2020,
	title = {Contribution of paramedics in primary and urgent care: a systematic review},
	volume = {70},
	issn = {0960-1643, 1478-5242},
	shorttitle = {Contribution of paramedics in primary and urgent care},
	url = {http://bjgp.org/lookup/doi/10.3399/bjgp20X709877},
	doi = {10.3399/bjgp20X709877},
	abstract = {Background Within the UK, there are now opportunities for paramedics to work across a variety of healthcare settings away from their traditional ambulance service employer, with many opting to move into primary care. Aim To provide an overview of the types of clinical roles paramedics are undertaking in primary and urgent care settings within the UK. Design and setting A systematic review.
Method Searches were conducted of MEDLINE, CINAHL, Embase, the National Institute for Health and Care Excellence, the Journal of Paramedic Practice, and the Cochrane Database from January 2004 to March 2019 for papers detailing the role, scope of practice, clinician and patient satisfaction, and costs of paramedics in primary and urgent care settings. Free-text keywords and subject headings focused on two key concepts: paramedic and general practice/primary care.
Results In total, 6765 references were screened by title and/or abstract. After full-text review, 24 studies were included. Key findings focused on the description of the clinical role, the clinical work environment, the contribution of paramedics to the primary care workforce, the clinical activities they undertook, patient satisfaction, and education and training for paramedics moving from the ambulance service into primary care.
Conclusion Current published research identifies that the role of the paramedic working in primary and urgent care is being advocated and implemented across the UK; however, there is insufficient detail regarding the clinical contribution of paramedics in these clinical settings. More research needs to be done to determine how, why, and in what context paramedics are now working in primary and urgent care, and what their overall contribution is to the primary care workforce.},
	language = {en},
	number = {695},
	urldate = {2020-05-29},
	journal = {British Journal of General Practice},
	author = {Eaton, Georgette and Wong, Geoff and Williams, Veronika and Roberts, Nia and Mahtani, Kamal R},
	month = jun,
	year = {2020},
	pages = {e421--e426},
	file = {Eaton et al. - 2020 - Contribution of paramedics in primary and urgent c.pdf:/Users/tricky999/Zotero/storage/ZG9L8YBC/Eaton et al. - 2020 - Contribution of paramedics in primary and urgent c.pdf:application/pdf}
}

@article{mason_evolution_2006,
	title = {The evolution of the emergency care practitioner role in {England}: experiences and impact},
	volume = {23},
	copyright = {Copyright 2006 by the Emergency Medicine Journal},
	issn = {1472-0205, 1472-0213},
	shorttitle = {The evolution of the emergency care practitioner role in {England}},
	url = {https://emj.bmj.com/content/23/6/435},
	doi = {10.1136/emj.2005.027300},
	abstract = {Background: The emergency care practitioner (ECP) is a generic practitioner who combines extended nursing and paramedic skills. The "new" role emerged out of changing workforce initiatives intended to improve staff career opportunities in the National Health Service and ensure that patients’ health needs are assessed appropriately.
Objective: To describe the development of ECP Schemes in 17 sites, identify criteria contributing to a successful operational framework, analyse routinely collected data and provide a preliminary estimate of costs.
Methods: There were three methods used: (a) a quantitative survey, comprising a questionnaire to project leaders in 17 sites, and analysis of data collected routinely; (b) qualitative interpretation based on telephone interviews in six sites; and (c) an economic costing study.
Results: Of 17 sites, 14 (82.5\%) responded to the questionnaire. Most ECPs (77.4\%) had trained as paramedics. Skills and competencies have been extended through educational programmes, training, and assessment. Routine data indicate that 54\% of patient contacts with the ECP service did not require a referral to another health professional or use of emergency transport. In a subset of six sites, factors contributing to a successful operational framework were strategic visions crossing traditional organisational boundaries and appropriately skilled workforce integrating flexibly with existing services. Issues across all schemes were patient safety, appropriate clinical governance, and supervision and workforce issues. On the data available, the mean cost per ECP patient contact is £24.00, which is less than an ED contact of £55.00.
Conclusion: Indications are that the ECP schemes are moving forward in line with original objectives and could be having a significant impact on the emergency services workload.},
	language = {en},
	number = {6},
	urldate = {2020-05-29},
	journal = {Emergency Medicine Journal},
	author = {Mason, S. and Coleman, P. and O’Keeffe, C. and Ratcliffe, J. and Nicholl, J.},
	month = jun,
	year = {2006},
	pmid = {16714501},
	note = {Publisher: British Association for Accident and Emergency Medicine
Section: Original Article},
	keywords = {emergency care practitioner, ED, emergency department, MIU, minor injury unit, DoH, Department of Health, avoided admission, ECP, emergency care practitioner, extended skills, GP, general practitioner, intermediate care, WIC, walk in centre},
	pages = {435--439},
	file = {Full Text:/Users/tricky999/Zotero/storage/9C3EPMNA/Mason et al. - 2006 - The evolution of the emergency care practitioner r.pdf:application/pdf;Snapshot:/Users/tricky999/Zotero/storage/5ZW9QNIS/435.html:text/html}
}

@phdthesis{long_out_2017,
	type = {{PhD}},
	title = {Out of the {Silo}: {A} {Qualitative} {Study} of {Paramedic} {Transition} to a {Specialist} {Role} in {Community} {Paramedicine}},
	shorttitle = {Out of the {Silo}},
	url = {https://eprints.qut.edu.au/114997},
	language = {en},
	urldate = {2020-05-29},
	school = {Queensland University of Technology},
	author = {Long, David N},
	month = dec,
	year = {2017},
	doi = {10.5204/thesis.eprints.114997},
	file = {Long - 2017 - Out of the Silo A Qualitative Study of Paramedic .pdf:/Users/tricky999/Zotero/storage/92E27W7F/Long - 2017 - Out of the Silo A Qualitative Study of Paramedic .pdf:application/pdf}
}

@article{bigham_expanding_2013,
	title = {Expanding {Paramedic} {Scope} of {Practice} in the {Community}: {A} {Systematic} {Review} of the {Literature}},
	volume = {17},
	issn = {1090-3127, 1545-0066},
	shorttitle = {Expanding {Paramedic} {Scope} of {Practice} in the {Community}},
	url = {https://www.tandfonline.com/doi/full/10.3109/10903127.2013.792890},
	doi = {10.3109/10903127.2013.792890},
	language = {en},
	number = {3},
	urldate = {2020-05-29},
	journal = {Prehospital Emergency Care},
	author = {Bigham, Blair L. and Kennedy, Sioban M. and Drennan, Ian and Morrison, Laurie J.},
	month = jul,
	year = {2013},
	pages = {361--372},
	file = {Bigham et al. - 2013 - Expanding Paramedic Scope of Practice in the Commu.pdf:/Users/tricky999/Zotero/storage/2QUGSI8Y/Bigham et al. - 2013 - Expanding Paramedic Scope of Practice in the Commu.pdf:application/pdf}
}

@article{mason_pragmatic_2012,
	title = {A pragmatic quasi-experimental multi-site community intervention trial evaluating the impact of {Emergency} {Care} {Practitioners} in different {UK} health settings on patient pathways ({NEECaP} {Trial})},
	volume = {29},
	issn = {1472-0205, 1472-0213},
	url = {http://emj.bmj.com/lookup/doi/10.1136/emj.2010.103572},
	doi = {10.1136/emj.2010.103572},
	abstract = {Background Emergency Care Practitioners (ECPs) are operational in the UK in a variety of emergency and urgent care settings. However, there is little evidence of the effectiveness of ECPs within these different settings. The aim of this study was to evaluate the impact of ECPs on patient pathways and care in different emergency care settings.
Methods A pragmatic quasi-experimental multi-site community intervention trial comprising five matched pairs of intervention (ECP) and control services (usual care providers): ambulance, care home, minor injury unit, urgent care centre and GP out-of-hours. The main outcome being assessed was patient disposal pathway following the care episode.
Results 5525 patient episodes (n¼2363 intervention and n¼3162 control) were included in the study. A significantly greater percentage of patients were discharged by ECPs working in mobile settings such as the ambulance service (percentage diff. 36.7\%, 95\% CI 30.8\% to 42.7\%) and care home service (36.8\%, 26.7\% to 46.8\%). In static services such as out-of-hours (À17.9\%, À30.8\% to À42.7\%) and urgent care centres (À11.5\%, À18.0\% to À5.1\%), a significantly greater percentage of patients were discharged by usual care providers.
Conclusions ECPs have a differential impact compared with usual care providers dependent on the operational service settings. Maximal impact occurs when they operate in mobile settings when care is taken to the patient. In these settings ECPs have a broader range of skills than the usual care providers (eg, paramedic), and are targeted to specific clinical groups who can benefit from alternative pathways of care (such as older people who have fallen). Trial Registration No ISRCTN22085282 (Controlled trials.com).},
	language = {en},
	number = {1},
	urldate = {2020-05-29},
	journal = {Emergency Medicine Journal},
	author = {Mason, Suzanne and O'Keeffe, Colin and Knowles, Emma and Bradburn, Mike and Campbell, Mike and Coleman, Patricia and Stride, Chris and O'Hara, Rachel and Rick, Jo and Patterson, Malcolm},
	month = jan,
	year = {2012},
	pages = {47--53},
	file = {Mason et al. - 2012 - A pragmatic quasi-experimental multi-site communit.pdf:/Users/tricky999/Zotero/storage/TF5NQSMA/Mason et al. - 2012 - A pragmatic quasi-experimental multi-site communit.pdf:application/pdf}
}

@article{tohira_impact_2014,
	title = {The impact of new prehospital practitioners on ambulance transportation to the emergency department: a systematic review and meta-analysis},
	volume = {31},
	copyright = {Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions},
	issn = {1472-0205, 1472-0213},
	shorttitle = {The impact of new prehospital practitioners on ambulance transportation to the emergency department},
	url = {https://emj.bmj.com/content/31/e1/e88},
	doi = {10.1136/emermed-2013-202976},
	abstract = {Objective To conduct a systematic review and meta-analysis to examine the impact of new prehospital practitioners (NPPs), including emergency care practitioners (EmCPs), paramedic practitioners and extended care paramedics (ECPs), on ambulance transportation to the emergency department (ED).
Methods We searched MEDLINE, Embase, CINAHL and AUSTHealth databases, and hand searched emergency medicine journals and journal reference lists for relevant papers. To be included, studies were required to target one type of NPP and compare outcomes such as the frequencies of conveyance to the ED, discharge at scene, subsequent ED attendance and/or appropriateness of care between NPPs and conventional ambulance crews. Three investigators independently selected relevant studies. The risk of bias in individual studies was assessed using a validated checklist. We conducted meta-analyses for comparisons which had acceptable heterogeneity (I2{\textless}75\%) and reported pooled estimates of ORs with 95\% CIs.
Results 13 studies were identified from 16 584 citation reports. EmCPs were most frequently studied. The majority of studies (77\%) did not fully report important potential confounders. NPPs were less likely to convey patients to the ED and more likely to discharge patients at the scene than conventional ambulance crews. Pooled ORs for conveyance to the ED and discharge at the scene by ECPs were 0.09 (95\% CI 0.04 to 0.18) and 10.5 (95\% CI 5.8 to 19), respectively. The evidence for subsequent ED attendance and appropriateness of care was equivocal.
Conclusions The NPP schemes reduced transport to the ED; however, the appropriateness of the decision of the NPPs and the safety of patients were not well supported by the reported studies.},
	language = {en},
	number = {e1},
	urldate = {2020-05-29},
	journal = {Emergency Medicine Journal},
	author = {Tohira, Hideo and Williams, Teresa A. and Jacobs, Ian and Bremner, Alexandra and Finn, Judith},
	month = oct,
	year = {2014},
	pmid = {24243486},
	note = {Publisher: BMJ Publishing Group Ltd and the British Association for Accident \& Emergency Medicine
Section: Review},
	keywords = {emergency ambulance systems, paramedics, extended roles, emergency care systems},
	pages = {e88--e94},
	file = {Snapshot:/Users/tricky999/Zotero/storage/43KR2I6B/e88.html:text/html;Submitted Version:/Users/tricky999/Zotero/storage/532Y7M4Z/Tohira et al. - 2014 - The impact of new prehospital practitioners on amb.pdf:application/pdf}
}

@misc{college_of_paramedics_post-registration_2018,
	title = {Post-registration paramedic career framework - 4th edition},
	url = {https://collegeofparamedics.co.uk/COP/ProfessionalDevelopment/post_reg_career_framework.aspx},
	urldate = {2020-06-01},
	publisher = {CoP},
	author = {{College of Paramedics}},
	year = {2018},
	file = {June_Final_Paramedic_Career_Framework_4th_edition_2018_-_for_website (1).pdf:/Users/tricky999/Zotero/storage/HVSCGKYP/June_Final_Paramedic_Career_Framework_4th_edition_2018_-_for_website (1).pdf:application/pdf}
}

@misc{nhs_england_ambulance_2020,
	title = {Ambulance {Quality} {Indicators}},
	url = {https://www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/},
	urldate = {2020-06-01},
	author = {{NHS England}},
	year = {2020},
	file = {AmbSYS-timeseries-to-20200430.xlsx:/Users/tricky999/Zotero/storage/HVMXURKZ/AmbSYS-timeseries-to-20200430.xlsx:application/vnd.openxmlformats-officedocument.spreadsheetml.sheet;Statistics » Ambulance Quality Indicators:/Users/tricky999/Zotero/storage/S8UQ4DHE/ambulance-quality-indicators.html:text/html}
}

@misc{nhs_england_ambulance_2018,
	title = {Ambulance {Response} {Programme} {Review}},
	url = {https://www.england.nhs.uk/wp-content/uploads/2018/10/ambulance-response-programme-review.pdf},
	urldate = {2020-06-01},
	author = {{NHS England}},
	year = {2018},
	file = {ambulance-response-programme-review.pdf:/Users/tricky999/Zotero/storage/X6F5WE8Y/ambulance-response-programme-review.pdf:application/pdf}
}

@misc{association_of_ambulance_chief_executives_model_2019,
	title = {Model of rotational working aims to stop ambulance trusts spinning out of control - aace.org.uk},
	url = {https://aace.org.uk/news/model-of-rotational-working-aims-to-stop-ambulance-trusts-spinning-out-of-control/},
	urldate = {2020-06-01},
	author = {{Association of Ambulance Chief Executives}},
	year = {2019},
	file = {Model of rotational working aims to stop ambulance trusts spinning out of control - aace.org.uk:/Users/tricky999/Zotero/storage/LBFLS428/model-of-rotational-working-aims-to-stop-ambulance-trusts-spinning-out-of-control.html:text/html}
}

@misc{health_education_england_rotating_2019,
	title = {Rotating {Paramedic} {Pilot}: {Evaluation} report},
	publisher = {HEE},
	author = {{Health Education England}},
	year = {2019},
	file = {HEE Rotating Paramedics Pilot - Full Evaluation Report 1019 Final.pdf:/Users/tricky999/Zotero/storage/8AXD5UWI/HEE Rotating Paramedics Pilot - Full Evaluation Report 1019 Final.pdf:application/pdf}
}

@misc{nhs_improvement_national_2020,
	title = {National {Cost} {Collection} for the {NHS}},
	url = {https://www.england.nhs.uk/national-cost-collection/},
	urldate = {2021-04-26},
	author = {{NHS Improvement}},
	year = {2020},
	file = {National Cost Collection for the NHS | NHS Improvement:/Users/tricky999/Zotero/storage/TRJWQQMY/national-cost-collection.html:text/html}
}

@misc{national_institute_for_health_and_care_excellence_emergency_2018,
	title = {Emergency and acute medical care in over 16s: service delivery and organisation},
	shorttitle = {Overview {\textbar} {Emergency} and acute medical care in over 16s},
	url = {https://www.nice.org.uk/guidance/ng94},
	language = {eng},
	urldate = {2021-03-18},
	author = {{National Institute for Health and Care Excellence}},
	year = {2018},
	note = {Publisher: NICE},
	file = {Snapshot:/Users/tricky999/Zotero/storage/KIS59BLG/ng94.html:text/html}
}