What Is the Potential of Community Paramedicine to Fill Rural Health Care Gaps?

Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and d...

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Bibliographic Details
Published in:Journal of health care for the poor and underserved 2016-11, Vol.27 (4), p.144-158
Main Authors: Patterson, Davis G, Coulthard, Cynthia, Garberson, Lisa A, Wingrove, Gary, Larson, Eric H
Format: Article
Language:English
Subjects:
Chronic illnesses
Clinical outcomes
Community relations
Cost control
Discharge
Disease control
Emergency management
Emergency medical care
Emergency Medical Services
Emergency services
Geography
Health care
Health care expenditures
Health care policy
Health services
Health Services Accessibility
Health Services Needs and Demand
Hospital discharged
Hospitalization
Hospitals
Humans
Medicaid
Medical personnel
Palliative care
Patients
Population
Postal codes
Prevention programs
Preventive medicine
Primary care
Primary Health Care
Public health
Referrals
Rural areas
Rural communities
Rural Health
Rural Health Services
Structured interviews
Studies
United States
Vulnerability
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Summary:Community paramedicine (CP) uses emergency medical services (EMS) providers to help rural communities increase access to primary care and public health services. This study examined goals, activities, and outcomes of 31 rural-serving CP programs through structured interviews of program leaders and document review. Common goals included managing chronic disease (90.3%); and reducing emergency department visits (83.9%), hospital admissions/readmissions (83.9%), and costs (83.9%). Target populations included the chronically ill (90.3%), post-hospital discharge patients (80.6%), and frequent EMS users (64.5%). Community paramedicine programs engaged in bi-directional referrals most often with primary care facilities (67.7%), hospitals (54.8%), and home health (38.7%). Programs provided assessment, testing, preventive care, and post-discharge services. Reported outcomes were promising, but few programs used rigorous evaluation methods. Rural-serving CP programs provided services to shift costs to less expensive settings and provide appropriate care where vulnerable patients live, but more evidence is needed that care is safe, effective, and economical.
ISSN:1049-2089
1548-6869
1548-6869
DOI:10.1353/hpu.2016.0192