Emergency Medical Services (EMS): A Look at Disparities in Funding and Outcomes

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Key Points:

• Substantial geographic disparities in emergency medical services (EMS) exist based on urbanicity—for example, in rural areas more staff volunteer or work part time, response times are longer, paramedics typically have lower levels of certification, and EMS relies heavily on fee for service funding.
• EMS response times for patients with cardiac arrest are 10% longer in low-income neighborhoods than in high-income neighborhoods.
• Studies find substantial disparities in the provision of EMS based on race and sex.
• In a case study of eleven counties in California, local EMS agencies that served rural counties had lower per capita EMS funding and lower percentages of cases that met established quality standards.