Should Payment Policy Be Changed to Allow a Wider Range of EMS Transport Options? - 18/04/14
, Abby Alpert, PhD b, Gregg Margolis, PhD, NREMT-P c, Jeffrey Wasserman, PhD, MS b, Arthur L. Kellermann, MD, MPH dAbstract |
The Institute of Medicine and other national organizations have asserted that current payment policies strongly discourage emergency medical services (EMS) providers from transporting selected patients who call 911 to non-ED settings (eg, primary care clinics, mental health centers, dialysis centers) or from treating patients on scene. The limited literature available is consistent with the view that current payment policies incentivize transport of all 911 callers to a hospital ED, even those who might be better managed elsewhere. However, the potential benefits and risks of altering existing policy have not been adequately explored. There are theoretical benefits to encouraging EMS personnel to transport selected patients to alternate settings or even to provide definitive treatment on scene; however, existing evidence is insufficient to confirm the feasibility or safety of such a policy. In light of growing concerns about the high cost of emergency care and heavy use of EDs, assessing EMS transport options should be a high-priority topic for outcomes research.
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist and provided the following details: This research was supported by a contract with the US Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response to provide technical assistance to the Office of Policy, Strategic Planning, and Communication for Development, Implementation, and Evaluation of the National Health Security Strategy (contract HHSP233200800565G). |
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| The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Department of Health and Human Services or its components. |
Vol 63 - N° 5
P. 615 - mai 2014 Retour au numéro
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