The Pathfinder Service is a collaboration between the Irish National Ambulance Service and Beaumont Hospital, Ireland. It was implemented in 2020 as an alternative to the traditional ambulance response model. An Advanced Paramedic and an Occupational Therapist or Physiotherapist respond to Emergency Medical Services (EMS) calls. The Pathfinder team may treat patients at home or transport them to hospital. Follow-up care is also provided. The aim of this study was to conduct a micro-costing analysis from a health service perspective to assess the difference in EMS costs when provided by Pathfinder compared with the traditional ambulance response. The Pathfinder cohort was identified from Pathfinder records. A comparable cohort was identified who met Pathfinder inclusion criteria but had emergency department ambulance conveyance. Both cohorts were contacted by telephone, and consenting individuals were interviewed about their contacts with healthcare providers. The analysis compared the cohorts in terms of age, sex and frailty score, the proportion of individuals who used various services, and the volume and cost of services. The seven-day costs were accumulated into major cost groups and total cost, and the difference in mean costs were reported at 2023-€ price level. Patient satisfaction was also recorded. Data were obtained from 108 patients with Pathfinder dispatch and 89 with traditional ambulance dispatch. The mean cost of the Pathfinder service was €3315 while the mean costs of the traditional ambulance model was €5482. The mean cost difference (€2,167, p < .001) indicates that Pathfinder is cheaper than the traditional ambulance model. Ninety-eight percent of participants were very satisfied or more than satisfied with Pathfinder in comparison with 85% in the traditional ambulance response group. These results suggest Pathfinder is a service that achieves high patient satisfaction at a lower cost than the traditional ambulance response model.
Bernard et al. (2026) studied this question.