The 911 model in the US evolved to provide emergency care to those in need who are subsequently transported to a hospital. However, many people who do not have adequate primary care options end up calling 911 on a regular basis.
Options to help these patients include assessing their health conditions and steering them towards primary care. This both improves patients’ health and reduces the frequency of non-emergency calls to 911 dispatchers.
Other countries have been using community paramedics for quite some time, but the US has been slower to implement these types of programs. The Fire Protection Research Foundation (FPRF) providing funding to analyze the use of these alternative care programs. In 2016, Sreenivasan Ranganathan issued a substantial report on the use of such programs in the US.
A number of studies showed that:
- 30-50% of the transports to ERS were “inappropriate”
- 10-40% of these transports were low-acuity and could be cared for without transportation to an ER
Both the state of Idaho and Orange County, North Carolina independently altered their approaches to low-acuity patients in the late 1990s. In Orange County, paramedics with additional training treat, refer, and transport such patients to a primary care provider. Idaho was the first area to create Medicaid coverage and payment for “treat and release” and “respond and evaluate.”
These types of programs are especially valuable for rural areas which frequently suffer from both critical shortages of primary care physicians and long distances to get to a hospital or clinic. Having community paramedics who can help such patients get primary care greatly improves the standard of care for patients in rural areas.
As of February 2016, emergency dispatch units had launched about 300 such programs throughout the US. Pilot programs in 12 sites in California found that all of the programs have improved patient care after hospital discharge and prevented unnecessary ER visits.
In addition to improving the level of healthcare provided to patients, such programs should reduce the number of 911 calls and thus reduce the stress level for emergency dispatchers.