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Rural Health
Research Gateway

Emergency medical services (EMS) and trauma

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2025

  • Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
    This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health

2024

  • Understanding Rural Non-Emergent Emergency Department Use
    Research shows rural residents use emergency departments (ED) at higher rates than urban residents. Other studies suggest rural residents are more likely to visit the ED for a non-emergent reasons. This study used the 2014-17 Medical Expenditure Panel Survey to analyze factors associated with rural versus urban residents' non-emergent use of EDs.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Health services, Healthcare access, Hospitals and clinics

2023

  • Ambulance Deserts: Addressing Geographic Disparities in the Provision of Ambulance Services
    This two-year study aimed to identify geographic disparities in accessing ambulance services by building a database of ambulance service locations in year one and identifying and creating maps of ambulance deserts within each of the states in year two.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare access, Rural statistics and demographics, Transportation

2022

2021

  • Impact of the Opioid Crisis on Rural Emergency Departments
    This study used data from the Nationwide Emergency Department Sample and information from a panel of rural emergency care experts to assess the impact of the opioid crisis on rural emergency departments. Findings informed policies designed to help rural healthcare systems and communities address the growing problem of opioid abuse.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Mental and behavioral health, Substance use and treatment

2019

  • Analyzing Data from the Evidence-Based Telehealth Network Grant Program Grantees and Preparing Manuscripts to Further the Evidence Base for Tele-ED
    This project's main purpose was to analyze data using the revised Tele-Emergency Performance Assessment Reporting Tool gathered from Evidence-Based Tele-Emergency Network Grant Program grantees on all of their cases using telehealth in the emergency department (tele-ED) and a matched sample of non-tele-ED records to conduct comparative effectiveness analysis to help establish the evidence base for tele-ED.
    Research center: Rural Telehealth Research Center
    Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Telehealth
  • Cost of Running a Rural Ambulance Service
    This study will address the cost of running ambulance services in rural areas by organizational structure/source of funding, the factors contributing to differences in costs, and factors contributing to differences in financial viability.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare financing

2018

  • Implications of Rural Ambulance Service Closures
    The purpose of this project was to examine closed ambulance services and those ambulance services adjacent to the closed units. The ambulance services adjacent to those which closed were examined by service area, workload, and staffing for one year prior to and one year after the adjacent service closure.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Allied health professionals, Emergency medical services (EMS) and trauma, Frontier health, Health services, Workforce

2016

  • The Impact of Emergency Telemedicine on Timeliness, Process of Care, and Clinical Outcomes in Rural North Dakota Trauma Care
    This project was a comparative effectiveness study of North Dakota trauma patients to measure the impact of telemedicine-enabled emergency care between 2008-2014 on a number of issues.
    Research center: Rural Telehealth Research Center
    Topics: Emergency medical services (EMS) and trauma, Emergency preparedness and response, Hospitals and clinics
  • Use of Emergency Departments for Behavioral Health Related Care
    This project will study the prevalence of emergency department utilization for behavioral health diagnoses between rural and urban communities.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Emergency medical services (EMS) and trauma, Health services, Hospitals and clinics, Mental and behavioral health
  • What Is the Potential of Community Paramedicine to Fill Rural Healthcare Gaps?
    Community paramedicine (CP) has been promoted as a strategy to help communities achieve the Triple Aim of improving healthcare and population health while lowering costs. This study proposes to collect descriptive information on CP programs that can be identified in the U.S., and for those programs with outcome data, compare rural with urban programs in terms of their goals, services offered, outcomes measured, and results, where available.
    Research center: WWAMI Rural Health Research Center
    Topics: Allied health professionals, Emergency medical services (EMS) and trauma

2015

  • Pre-hospital Emergency Medical Services Personnel in Rural and Urban Areas: Results from a Survey in Nine States
    This study uses a survey of all ground-based pre-hospital emergency medical services (EMS) agencies in nine states (AR, FL, KS, MA, MT, NM, OR, SC, WI) to examine supply and demand for emergency response personnel, the involvement of medical directors, and the availability of medical consultation, in rural and urban agencies.
    Research center: WWAMI Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Workforce
  • Use and Performance Variations in Rural Emergency Departments: Implications for Improving Care Quality and Reducing Costs
    This project describes rural usage of rural emergency departments (EDs). It will examine the conditions that are treated in these EDs and describe those that are more and less appropriate for ED use. Rural ED use is described by community characteristics including rural level. The findings provide a baseline from which to measure the future influence of the Accountable Care Act implementation on the usage of rural EDs and the appropriateness and cost efficiency of changes.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Emergency medical services (EMS) and trauma, Quality

2010

  • Exploring the Black Box: Design and Implementation Issues of P4P for Rural Physicians
    Information about how pay-for-performance (P4P) payment systems work in ambulatory care settings, and in particular, how rural physicians might be affected, is scarce. This study employs qualitative research methods to explore the design and implementation of P4P systems and to investigate effects of P4P on rural physicians in a variety of settings.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Emergency medical services (EMS) and trauma, Healthcare financing, Physicians
  • Factors Associated with Provision of Ambulance Services by Rural Hospitals
    This two-part study will use existing national data to determine how many hospitals have regularly offered ambulance services as well as how many have recently acquired or discontinued such services. In-depth interviews with selected rural hospital administrators will explore the factors related to a hospital's decision regarding these important health care services.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Emergency medical services (EMS) and trauma
  • Organizational Impact of the Deployment of Ambulance Quality Feedback Systems (QFS) on Rural Volunteer EMS Agencies
    Topic: Emergency medical services (EMS) and trauma
  • Volunteerism in Rural EMS
    Semi-structured telephone interviews will be used to examine issues facing rural emergency medical services (EMS) that have converted or are considering converting from volunteer services to paid services. Respondents will be queried regarding their conversion or consideration of conversion and the effect on their ability to recruit and retain personnel, their relationship with other agencies such as fire departments and hospitals, and the overall availability of EMS.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare financing, Workforce

2009

  • Turnover Costs in Rural Emergency Medical Services
    Costs associated with providing Emergency Medical Services (EMS) transportation in rural areas are much higher than in urban communities. This study will measure the annual rate of turnover among rural EMS systems, identify costs associated with turnover, and create a budgeting tool for calculating the costs of turnover.
    Research center: FORHP-funded Individual Grantees
    Topics: Emergency medical services (EMS) and trauma, Transportation, Workforce

2008

2007

  • Rural Emergency Department Staffing: Implications for the Quality of Emergency Care Provided in Rural Areas
    This project will describe emergency department (ED) staffing patterns in rural hospitals; determine how the certification, training, and experience of ED physicians and other providers in different ED staffing models vary; and assess the implications of rural ED staffing for the quality of emergency care in rural areas, continuity of care, and rural EDs' role as safety net providers.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Quality, Workforce
  • Rural Emergency Medical Services: Workforce and Medical Direction
    This two year study will examine the status of medical direction for rural EMS systems and the nature of the challenges and impediments to obtaining adequate medical direction in rural areas across the country. In addition, the study will address issues surrounding the recruitment and retention of paid and volunteer staff for rural EMS systems.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Emergency medical services (EMS) and trauma, Workforce

2005

  • Mental Health Encounters in Critical Access Hospital Emergency Rooms: A National Survey
    This project will survey Emergency Room (ER) managers in a nationally representative sample of Critical Access Hospitals (CAHs) to determine the proportion of ER encounters involving mental health pathology, types of mental health problems most commonly seen in these encounters, and resources available to CAHs to address the problems encountered.
    Research center: Maine Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Mental and behavioral health
  • Special Study of EMS Issues
    This study will focus on state, community, and hospital level initiatives designed to build the infrastructure to support EMS service capacity and encourage the integration of these services into the rural healthcare infrastructure in the areas of quality improvement, financing, staffing, medical control, and networking and integration.
    Research centers: Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
    Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Networking and collaboration

2003

2002

2001