{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:47:06Z","timestamp":1782467226466,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify factors associated with paramedic transport to hospital for older people in residential aged care facilities (RACFs) and supported accommodation, and to identify modifiable drivers of non\u2010transport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective cohort study using routinely collected electronic patient care records, analysed with gradient boosting models and multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Ambulance Tasmania attendances to RACFs and supported accommodation across Tasmania, 1\u2009January 2018 to 31 December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Population<\/jats:title>\n                    <jats:p>All eligible ambulance attendances for people aged 65\u2009years or older at these facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>The primary outcome was transport to hospital. Scene time and clinical status at first assessment, summarised using the National Early Warning Score 2 (NEWS2) and Shock Index, were descriptive variables and candidate predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 23,317 attendances, 19,386 (83.1%) resulted in transport and 3931 (16.9%) did not. Most attendances were low risk. Crew skill set, calendar month, initial pain score, respiratory rate and NEWS2 category were the strongest predictors of transport. In adjusted logistic regression, extended care paramedic attendance was associated with markedly lower odds of transport than attendance by standard paramedic crews (adjusted odds ratio, 0.09 [95% CI, 0.07\u20130.12]), corresponding to an adjusted transport probability of 0.50 compared with 0.85 for intensive care paramedic crews, 0.86 for standard paramedic crews and 0.69 for other crews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Paramedic transport decisions for RACF residents were strongly associated with acute illness severity, but crew skill set was also independently associated with transport. Attendances managed by extended care paramedics had lower adjusted probabilities of hospital transport. These findings suggest that extended\u2010scope paramedic models warrant prospective evaluation in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70211","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T03:50:42Z","timestamp":1780372242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Ambulance Transport to Hospital for Older People Living in Tasmanian Aged Care Facilities: A Retrospective Cohort Study"],"prefix":"10.5694","volume":"224","author":[{"given":"Sharon","family":"Andrews","sequence":"first","affiliation":[{"name":"School of Nursing University of Tasmania  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter F.","family":"Fouche","sequence":"additional","affiliation":[{"name":"School of Paramedicine and Public Safety University of Tasmania  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Flanagan","sequence":"additional","affiliation":[{"name":"School of Paramedicine and Public Safety University of Tasmania  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McDermott","sequence":"additional","affiliation":[{"name":"Ambulance Tasmania  Hobart Tasmania Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Greenwood","sequence":"additional","affiliation":[{"name":"School of Nursing University of Tasmania  Sydney New South Wales Australia"},{"name":"School of Nursing University of Tasmania  Hobart Tasmanaia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.13005"},{"key":"e_1_2_13_3_1","unstructured":"Australian Institute of Health and Welfare \u201cGEN Fact Sheet 2023\u201324: People Using Aged Care \u201d2025 https:\/\/www.gen\u2010agedcaredata.gov.au\/Topics\/People\u2010using\u2010aged\u2010care."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-03895-1"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy056"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678-022-00363-4"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02736.x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-14-80"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-025-01264-2"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2008.060327"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH24230"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12980"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu117"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaf030"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0311019"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1028-z"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.colegn.2020.05.008"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17113778"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1355819614558472"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.12803"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-024-01294-y"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_13_23_1","unstructured":"Royal College of Physicians \u201cNational Early Warning Score (NEWS) 2: Standardising the Assessment of Acute\u2010Illness Severity in the NHS \u201dUpdated Report of a Working Party London: Royal College of Physicians 2017 https:\/\/www.rcp.ac.uk\/media\/a4ibkkbf\/news2\u2010final\u2010report_0_0.pdf."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0300-9572(92)90006-X"},{"key":"e_1_2_13_25_1","unstructured":"H2O.ai \u201cH2O: Scalable Machine Learning Platform. 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