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Configurations of EMS systems : a pilot study
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    Emergency medical services (EMS) systems are configured differently depending on several factors, including the size, demographics, geography, and politics of the local communities they serve. Although some information exists about the organization, financing, and delivery of EMS in the Nation’s 200 largest cities, there is less information available about how services are organized outside large urban areas, in which 75% of the nation’s population resides. There is little evidence to support alternative system designs and configurations in terms of their impact on the effectiveness and efficiency of service delivery. To this end, there is a need to develop a typology of system configurations so they may be evaluated on a common basis. This pilot research attempts to develop such a typology by characterizing local EMS systems in the Mid-Atlantic region of the United States. EMS systems were invited to respond to a 20-question survey to assess their structural components and response configurations as well as topics such as system access, financing, medical direction, and operating procedures. Respondents also provided subjective assessments of additional system features and environmental factors. An 86.1% response rate was achieved. Many responses varied both within and across States. Many system characteristics also varied significantly by the level of rurality, including system access, primary agency types, and operating procedures. Overall, respondents indicated positive system environments and support structures within their systems. With slight modification, this pilot research could be repeated on a national scale.

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