Emergency medical services (EMS) and trauma

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2023

  • Rural Emergency Hospital Map and Data
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 10/2023
    This interactive map tracks hospitals that have converted to Rural Emergency Hospitals since January 2023.
  • Suitability of Low-Volume Rural Emergency Departments to New Rural Emergency Hospital Designation
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 09/2023
    The Rural Emergency Hospital is a new Medicare payment model that requires hospitals to focus on emergency, observation, and outpatient services in lieu of inpatient care. This study's exploratory objective was to examine care delivery from eligible hospitals to assess their fit with the new payment model.
  • A Consensus Panel Approach to Estimating the Start-Up and Annual Service Costs for Rural Ambulance Agencies
    Policy Brief
    Maine Rural Health Research Center
    Date: 08/2023
    This brief fills the information void on the costs of running rural ambulance services and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station, enabling policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services.
  • Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
    Chartbook
    Maine Rural Health Research Center
    Date: 05/2023
    Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.

2022

2021

2020

2019

  • Emergency Department Telemedicine Consults Decrease Time to Interpret Computed Tomography of the Head in a Multi-Network Cohort
    Journal Article
    Rural Telehealth Research Center
    Date: 11/2019
    This was a study of emergency telemedicine (tele-ED) for stroke care in four tele-ED networks. Tele-ED was associated with decreased time to diagnostic imaging interpretation and time to thrombolytic medication. The effect of tele-ED varied by network, suggesting network characteristics may influence the realized tele-ED benefit for stroke care.
  • Hospital Closures and Short-Run Change in Ambulance Call Times
    Journal Article
    Rural and Underserved Health Research Center
    Date: 11/2019
    Hospital closures affect the availability of emergency department services. This paper examines changes in ambulance ride times in areas with hospital closures compared to those in similar areas without hospital closures and separately analyzes changes in ambulance ride times between urban and rural areas and among Medicare-eligible patients.
  • Tele-Emergency Behavioral Health in Rural and Underserved Areas
    Journal Article
    Rural Telehealth Research Center
    Date: 11/2019
    This paper describes how two distinct tele-emergency department (ED) behavioral health models address challenges in access and placement for patients in rural and underserved areas presenting to EDs. The notable difference in disposition rates between cases and controls shows the impact each model is having on care practices and processes.
  • Pediatric Tele-Emergency Care: A Study of Two Delivery Models
    Journal Article
    Rural Telehealth Research Center
    Date: 04/2019
    This study describes two tele-emergency programs that provide care to pediatric populations. Qualitative descriptions of the two tele-emergency department (ED) models and key characteristics of the patient populations served by tele-ED are presented. The study informs others about evaluative measures and how tele-ED works in practice.
  • Do Hospital Closures Affect Patient Time in an Ambulance?
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2019
    Our study explores how a local hospital closure changes patient time in an ambulance for 9-1-1 calls. Access to emergency department services in communities, especially rural communities, persists as a priority for the Medicare program. We found when hospitals close, rural patients requiring ambulance services are disproportionately affected.

2018

2017

2016

  • What Is the Potential of Community Paramedicine to Fill Rural Healthcare Gaps?
    Journal Article
    WWAMI Rural Health Research Center
    Date: 11/2016
    This study collected information on rural community paramedicine in the U.S. programs to describe their goals, target populations, services offered, connections with local community providers and resources, outcomes measured, and results, where available.

2015

2010

  • Rural Hospital Support for Emergency Medical Services (Final Report)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2010
    This report shares information on rural hospitals related to these questions: what proportion support/operate emergency medical services (EMS) units; has this changed; what are the characteristics of the hospitals that support/operate EMS; what investments were made in EMS; and what describes the communities where the hospitals are located?
  • Rural Hospital Support for Emergency Medical Services (Findings Brief)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2010
    This study looked at rural hospitals to answer these questions: what proportion support/operate emergency medical services (EMS) units; has this changed; what are the characteristics of the hospitals that support/operate EMS; what financial investments were made in EMS; and what describes the communities where the hospitals are located?
  • Rural Volunteer EMS: Reports From the Field (Findings Brief)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 09/2010
    This report explores the current state of rural EMS by interviewing 49 local directors from all-volunteer rural services in 23 states. Respondents were encouraged to speculate on the future viability of their local service, describe the challenges they face, and what they need to ensure continuance.
  • Rural Volunteer EMS: Reports From the Field (Final Report)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2010
    This report explores the current state of rural EMS by interviewing 49 local directors from all-volunteer rural services in 23 states. Respondents were encouraged to speculate on the future viability of their local service, describe the challenges they face, and what they need to ensure continuance.
  • Pediatric Care in Rural Hospital Emergency Departments (Final Report)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2010
    This report analyzes data from the Emergency Pediatric Services and Equipment Supplement to the National Hospital Ambulatory Medicare Care Survey to compare rural and urban hospitals' responses on various dimensions of pediatric emergency department care.
  • Pediatric Care in Rural Hospital Emergency Departments (Findings Brief)
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2010
    This brief analyzes data from the Emergency Pediatric Services and Equipment Supplement to the National Hospital Ambulatory Medical Care Survey. Rural/urban hospitals' responses on pediatric emergency department (ED) care were compared. Rural ED directors also were surveyed to further explore rural pediatric ED care in more detail.

2008

2007

2006

2005

2004

2003

2002

  • Federal Funding for Emergency Medical Services
    NORC Walsh Center for Rural Health Analysis
    Date: 07/2002
    This report includes recent trend data from 1994 to the present on aggregate federal spending on emergency medical services (EMS) and funding targeted explicitly to rural areas. It also discusses the role various federal agencies have played and traces the history of federal legislation to support EMS programs.
  • Essential Research Issues in Rural Health: The State Rural Health Directors' Perspective
    NORC Walsh Center for Rural Health Analysis
    Date: 03/2002
    This policy brief describes the key issues confronting state rural health directors. Issues repeatedly raised by directors from a wide variety of states included workforce, telemedicine, emergency medical services, mental health, and lack of local data.
  • Access to Emergency Medical Services in Rural Areas: The Supporting Role of State EMS Agencies
    University of Minnesota Rural Health Research Center
    Date: 02/2002
    This paper reports on a survey of state emergency medical services (EMS) directors about access to rural EMS; programs/initiatives by state EMS agencies to target rural/volunteer EMS providers; integration initiatives by rural EMS providers; issues in medical direction for rural EMS; and anticipated effects of the new Medicare fee schedule.

2001

2000

  • The Effect of the Doctor-Patient Relationship on Emergency Department Use Among the Elderly
    Journal Article
    WWAMI Rural Health Research Center
    Date: 01/2000
    OBJECTIVES: This study sought to determine the rate of emergency department use among the elderly and examined whether that use is reduced if the patient has a principal-care physician.
    METHODS: The Health Care Financing Administration's National Claims History File was used to study emergency department use by Medicare patients older than 65 years in Washington State during 1994. RESULTS: A total of 18.1% of patients had 1 or more emergency department visits during the study year; the rate increased with age and illness severity. Patients with principal-care physicians were much less likely to use the emergency department for every category of disease severity. After case mix, Medicaid eligibility, and rural/urban residence were controlled for, the odds ratio for having any emergency department visit was 0.47 for patients with a generalist principal-care physician and 0.58 for patients with a specialist principal-care physician.
    CONCLUSIONS: The rate of emergency department use among the elderly is substantial, and most visits are for serious medical problems. The presence of a continuous relationship with a physician--regardless of specialty--may reduce emergency department use.
  • Emergency Department Use by the Rural Elderly
    Journal Article
    WWAMI Rural Health Research Center
    Date: 2000
    This study uses Medicare data to compare emergency department (ED) use by rural and urban elderly beneficiaries. Given the similarity of diagnostic conditions associated with ED visits, rural EDs must be capable of dealing with the same range of emergency conditions as urban EDs.