Background Community paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development.
Methods A series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively. Each CP programme uses its own model with unique goals, as well as providing corresponding services/care based on the demands from their communities.
Results Three CP programmes in the study were mainly aimed at reducing healthcare resource utilisation (ie, reduce readmissions or ED utilisation), but one of the programmes developed a sustainable model aiding newborn care in the community. Establishing a solid reimbursement mechanism and working closely with collaborators are two major strategies for developing sustainable CP programmes. Complete data collection and a programme evaluation process will also be important to demonstrate the value of its CP models to potential collaborators and policy-makers. However, the cost-effectiveness of a CP model is still not easy to identify due to the separate programmes being developed without uniform goals.
Conclusion The challenges and solutions from the four programmes under study can provide a road map for the development of CP programmes for other communities.
- community paramedicine
- emergency medical services
- community health
- rural health
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Contributors Y-HH contributed to the design of the study. The manuscript proposal was written by LM under the guidance of Y-HH. LM completed the ethics committee application. Data acquisition was performed by LM, LAS and ZAP. The manuscript was written by Y-HH and revisions provided by Y-HH as well. All authors approved the final manuscript.
Funding This study is funded by NSF I/UCRC (award number 1624727).
Competing interests None declared.
Patient consent Not required.
Ethics approval Penn State IRB.
Provenance and peer review Not commissioned; externally peer reviewed.