Abstract
Beginning in 2006, Toronto Emergency Medical Services (EMS) developed the Community Referrals by EMS (CREMS) program in which paramedics directly refer patients for home care and community support services such as meals on wheels. This retrospective cohort study assessed the utilization of home and community support services and EMS services among individuals who received CREMS referral in Toronto, Canada in 2011 and 2012. In all, 2,382 individuals received CREMS referral, with a mean age of 79.0 years (SD 13.6). In the 6 months after CREMS referral, there was an adjusted increase of 17.4 hours of support services per person (95% CI: 1.74, 33.09, p=0.03) and an adjusted reduction in calls to EMS by 0.19 fewer mean calls per person (95% CI -0.31, -0.06, p=0.004). The CREMS Program may represent a simple and effective way to address unmet needs for community-dwelling elders.