Association Between Primary Care Availability and Emergency Medical Services Utilization

Gregory Jasani; Yuanyuan Liang; Bryan McNeilly; Benoit Stryckman; David Marcozzi; Daniel Gingold

doi:10.1016/j.jemermed.2023.01.002

Association Between Primary Care Availability and Emergency Medical Services Utilization

J Emerg Med. 2023 Apr;64(4):448-454. doi: 10.1016/j.jemermed.2023.01.002. Epub 2023 Mar 27.

Authors

Gregory Jasani¹, Yuanyuan Liang², Bryan McNeilly³, Benoit Stryckman¹, David Marcozzi⁴, Daniel Gingold¹

Affiliations

¹ Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
² Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
³ Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland.
⁴ Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.

PMID: 36990852
DOI: 10.1016/j.jemermed.2023.01.002

Abstract

Background: Emergency medical services (EMS) contribute to the vital role of providing health care to an individual by delivering time-sensitive, episodic treatment to patients with acute illnesses. Understanding which factors impact EMS utilization can help guide policies and allocate resources more effectively. Increasing primary care access has often been touted to decrease unnecessary emergency care utilization.

Objectives: This study seeks to determine whether a relationship exists between access to primary care and EMS utilization.

Methods: Using data from the National Emergency Medical Services Information System, Area Health Resources Files, and County Health Rankings and Roadmaps, U.S. county-level data were analyzed to determine whether increased access to primary care (and insurance coverage) was associated with decreased EMS utilization.

Results: Higher primary care availability is associated with less EMS utilization only when insurance coverage in the community surpassed 90%.

Conclusions: Insurance coverage can play an important role in decreasing EMS utilization and may also impact the effect of increased primary care physician availability on EMS utilization in a region.

Keywords: EMS; access to care; emergency medical services; health policy; insurance; primary care; social determinants of health.

MeSH terms

Delivery of Health Care
Emergency Medical Services*
Health Resources
Humans
Primary Health Care
Surveys and Questionnaires