Goals, Services, and Target Patient Populations of Community Paramedicine in Rural United States

Abstract

Introduction: Rural areas contain one-fifth of the US population and only 10% of the nation’s physicians. Community paramedicine (CP) is a growing healthcare delivery model in which emergency medical personnel provide non-emergent medical care. Community paramedics may help fill the primary healthcare gap for rural residents. This literature review provides an overview of the common goals, services, target populations, and setbacks of rural CP programs in the US. Methods: A systematic search following PRISMA protocols was completed on PubMed and Google scholar using the search terms: “community paramedicine/paramedic” and “rural, remote, frontier” between 2000-2021. Results: Rural CP program goals are to aid patients in chronic disease management and reduce emergency department visits, hospital admissions/readmissions, and healthcare costs. Programs target services toward patients who are chronically ill, post-hospital discharge, and frequent EMS users. Conclusion: CP provision of preventative and primary care services has improved health outcomes for patients with chronic disease. Programs report cost savings for the healthcare payer and patient and a reduction in ED transports and hospital readmissions. The problems identified are acquiring sustainable funding to develop CP programs and reimburse CP services, lack of consistency between CP scope of practice and educational requirements across states, role tensions with other healthcare professions, and lack of research about the safety of CP programs for patients. Future research is needed to investigate patient outcomes secondary to CP preventative and primary care services, which may identify if CPs are an effective means of helping fill the primary care gap for rural communities.