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PP45 Ambulance service recognition of health inequalities and activities to reduce health inequalities: an evidence and gap map
  1. Fiona Bell1,
  2. Ruth Crabtree1,
  3. Caitlin Wilson1,
  4. Elisha Miller1,
  5. Rachel Byrne2
  1. 1Yorkshire Ambulance Service NHS Trust, UK
  2. 2South West Yorkshire Partnership NHS Foundation Trust


Background Emergency medical services (EMS) are often patients’ first point of contact for urgent and emergency care needs. Patients are triaged over the phone and may subsequently receive an ambulance response with potential conveyance to hospital. A recent scoping review suggested disparities in EMS patient care in the United States, but it is unknown how health inequalities impact EMS care in other developed countries and how inequalities are being addressed. The aim of this rapid evidence map of published literature was to map known health inequalities in EMS patients and describe interventions reducing EMS health inequalities.

Methods The search strategy consisted of EMS synonyms and inequality synonyms. Databases searched from January 2010 to July 2022 were MEDLINE and PubMed. Studies were included if they described empirical research in a country with ambulance services providing patient care. Included studies were mapped on to the EMS care interventions framework and CORE20PLUS5 framework. Studies evaluating interventions were synthesised using the UK Allied Health Professions Public Health Strategic Framework.

Results The search strategy yielded 771 articles excluding duplicates, with a further 2 studies added from hand-searches. 100 studies met the inclusion criteria after full-text review. Inequalities in EMS patient care were predominantly situated in assessment, treatment and conveyance, although triage and response performance were also represented. Studies mostly explored EMS health inequalities within ethnic minority populations, populations with protected characteristics and also on the core issue of social deprivation. Studies evaluating interventions reducing health inequalities (n=5) were from outside the UK and focused on elderly patients, ethnic minorities and limited English proficiency. Interventions included community paramedics, awareness campaigns, dedicated language lines and changes to EMS protocols.

Conclusions Further UK-based research exploring health inequalities of EMS patients would support ambulance service policy and intervention development to reduce health inequality in urgent and emergency care delivery.

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