The CDC released a series of reports on 10/9/2024 highlighting EMS delivery challenges.
The reports are summarized below, and there are links to PDFs of the full reports at the end of the summary.
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Emergency Medical Services (EMS): A Look at Disparities in Funding and Outcomes
https://www.cdc.gov/ems-community-paramedicine/php/us/disparities.html
Key points
- Substantial geographic disparities in emergency medical services (EMS) exist based on urbanicity—for example, in rural areas more staff volunteer or work part time, response times are longer, paramedics typically have lower levels of certification, and EMS relies heavily on fee for service funding.
- EMS response times for patients with cardiac arrest are 10% longer in low-income neighborhoods than in high-income neighborhoods.
- Studies find substantial disparities in the provision of EMS based on race and sex.
- In a case study of eleven counties in California, local EMS agencies that served rural counties had lower per capita EMS funding and lower percentages of cases that met established quality standards.
Nationwide EMS challenges
Despite widespread popular support for additional EMS funding, limited EMS resources contribute to service-related challenges throughout the nation. Recruiting qualified emergency medical technicians (EMTs) can be difficult because of:
- Low salaries (national average: $34,320)
- High turnover
- Lack of racial equity among staff (in 2019, 86.6% of EMTs were White)
- Insufficient operations support:
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- Reports of ambulances held together with duct tape
- Reports of bake sales to raise money for fuel
- Little recognition of EMS role in public health
- Poor opportunities for staff training
Geographic disparities in EMS
Geographic disparities in EMS based on urbanicity have been identified nationwide. Specifically, rural areas have:
- Greater reliance on volunteers and/or part-time staff
- Paramedics with basic, rather than advanced, life support certification
- EMS paramedics who are less likely to receive prearrival instructions
- Heavier reliance on fee-for-service funding
- Longer prehospital response and transport times
- EMS systems that lack consistent medical oversight, which affects outcomes
- Higher rates of patients who require EMS transport
- Substantially higher costs for pregnant women with preterm labor
Emergency Medical Services (EMS): Local Authority, Funding, Organization, and Management
https://www.cdc.gov/ems-community-paramedicine/php/us/local-authority.html
Key points
- Unlike police and fire services, emergency medical services (EMS) are rarely classified and funded as "essential services."
- EMS are primarily funded at the local level and often severely underfunded.
- Administration, management, and oversight of EMS systems vary greatly but typically involve collaboration among multiple sectors.
- Local government autonomy may play a crucial role in giving local governments the flexibility to create and fund EMS with limited local resources.
Emergency Medical Services (EMS)_ Local Authority, Funding, Organization, and Management _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Equity in U.S. Emergency Medical Services (EMS)_ A Case Study in California _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Table 2b_ State Laws for Mutual Aid Contracts, Bonds, and Fees in Effect as of January 31, 2022 _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Table 2a_ State Laws Related to Statewide Local Government Autonomy in Effect as of January 31, 2022 _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Table 1_ Summary of Laws Pertaining to Local Government Autonomy and Local EMS Funding Mechanisms, in Effect as of January 31, 2022 _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Emergency Medical Services (EMS) Home Rule State Law Fact Sheet _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Appendix_ Detailed Methodology and Data Sources _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
Emergency Medical Services (EMS)_ A Look at Disparities in Funding and Outcomes _ Emergency Medical Services (EMS) and Community Paramedicine _ CDC.pdf
