Rural Emergency Medical Services (EMS) and Trauma – Resources
Selected recent or important resources focusing on Rural Emergency Medical Services (EMS) and Trauma.
How Should Rural EMS Funding Streams Be Improved?
Discusses the need and mechanisms for funding rural EMS systems more robustly. Offers suggestions for finding funding and discusses the decline in volunteerism.
Author(s): James Small
Citation: AMA Journal of Ethics, 27(7), E518-524
Date: 07/2025
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Discusses the need and mechanisms for funding rural EMS systems more robustly. Offers suggestions for finding funding and discusses the decline in volunteerism.
Author(s): James Small
Citation: AMA Journal of Ethics, 27(7), E518-524
Date: 07/2025
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Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Rurality and Area Deprivation and Outcomes After Out-of-Hospital Cardiac Arrest
Results of a study exploring the association between neighborhood rurality or economic deprivation with regional variation in outcomes after out-of-hospital cardiac arrest (OHCA). Features patient demographics and statistics with breakdowns by rural, suburban, and urban areas.
Author(s): Lakota Cheek, Robert H. Schmicker, Remle Crowe, et al.
Citation: JAMA Network Open, 8(4), e253435
Date: 04/2025
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Results of a study exploring the association between neighborhood rurality or economic deprivation with regional variation in outcomes after out-of-hospital cardiac arrest (OHCA). Features patient demographics and statistics with breakdowns by rural, suburban, and urban areas.
Author(s): Lakota Cheek, Robert H. Schmicker, Remle Crowe, et al.
Citation: JAMA Network Open, 8(4), e253435
Date: 04/2025
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Strategies for Sustaining Emergency Care in the United States
Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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Assesses the value of emergency care in the United States, evaluates challenges to sustaining emergency care, measures trends in emergency care payment, and identifies alternate funding strategies for emergency care. Features a case study of a hospital-based emergency department closure in a rural community, and mentions rural throughout.
Author(s): Mahshid Abir, Brian Briscombe, Carl T. Berdahl, et al.
Date: 04/2025
Sponsoring organization: RAND Corporation
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Epidemiology of 911 Calls for Opioid Overdose in Nogales, Arizona
Presents a study reviewing the 911 calls pertaining to opioid overdose in the Nogales, AZ area. Details the prehospital care received in the rural, borderland community and evaluates EMS's adherence to naloxone distribution protocol.
Author(s): Melody Glenn, Darien Stratton, Keith Primeau, Amber Rice
Citation: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 26(3)
Date: 03/2025
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Presents a study reviewing the 911 calls pertaining to opioid overdose in the Nogales, AZ area. Details the prehospital care received in the rural, borderland community and evaluates EMS's adherence to naloxone distribution protocol.
Author(s): Melody Glenn, Darien Stratton, Keith Primeau, Amber Rice
Citation: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 26(3)
Date: 03/2025
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AHRQ Summit to Address Emergency Department Boarding: Technical Report
Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Report from an October 2024 Agency for Healthcare Research and Quality (AHRQ) summit to discuss emergency department boarding. Examines some of emergency physicians' biggest concerns and highlights possible solutions to address boarding head-on, including enhancing measurement and standards, re-aligning hospital incentives, and increasing support to empower emergency physicians to do their jobs effectively. Includes sections on rural patients and rural areas.
Author(s): Robin M. Weinick, Sean Bruna, Rachael M. Boicourt, Sean S. Michael, Laura L. Sessums
Date: 01/2025
Sponsoring organization: Agency for Healthcare Research and Quality
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Travel Time as an Indicator of Poor Access to Care in Surgical Emergencies
Results of a study to determine how proximity to emergency care impacts disease complexity for patients with acute surgical conditions. Features statistics including sociodemographic and clinical characteristics by travel time, with breakdowns by rural, micropolitan, and metropolitan areas.
Author(s): Nina M. Clark, Alexandra H. Hernandez, Mia S. Bertalan, et al.
Citation: JAMA Network Open, 8(1), e2455258
Date: 01/2025
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Results of a study to determine how proximity to emergency care impacts disease complexity for patients with acute surgical conditions. Features statistics including sociodemographic and clinical characteristics by travel time, with breakdowns by rural, micropolitan, and metropolitan areas.
Author(s): Nina M. Clark, Alexandra H. Hernandez, Mia S. Bertalan, et al.
Citation: JAMA Network Open, 8(1), e2455258
Date: 01/2025
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Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During COVID-19
Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Emergency Triage, Treat, and Transport (ET3) Model: Final Evaluation Report
Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Presents quantitative and qualitative results from the evaluation of the Emergency Triage, Treat, and Transport (ET3) Model, a voluntary model that allowed ambulance care teams to use alternate models of emergency healthcare to improve quality and lower care costs. Describes the characteristics of ET3 participants, the extent to which ET3 interventions successfully prevented emergency department (ED) visits, and how average Medicare Parts A and B spending for patients that received ET3 interventions compared to patients who had low acuity ED visits. Discusses challenges and barriers to delivering ET3 interventions. Includes rural references throughout.
Additional links: Findings at a Glance, Technical Appendix
Date: 01/2025
Sponsoring organization: Centers for Medicare & Medicaid Services
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Medicare Ground Ambulance Data Collection System (GADCS) Report: Year 1 and Year 2 Cohort Analysis
Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Additional links: Codebook
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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Provides data from the first two cohorts of ground ambulance organizations selected to participate in the Ground Ambulance Data Collection System. Includes response rates, information on data cleaning and validation, statistics summarizing responses, and analyses exploring relationships between costs per service and organizational characteristics. Features statistics with breakdowns by urban, rural, and super rural areas.
Additional links: Codebook
Author(s): Andrew W. Mulcahy, Sara E. Heins, Petra W. Rasmussen, et al.
Date: 12/2024
Sponsoring organizations: Centers for Medicare & Medicaid Services, RAND Corporation
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