Emergency medical service- based care coordination for three rural communities

Cara L. Pennel, Loida Tamayo, Rebecca Wells, Tenaya Sunbury

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Providers in rural areas face challenges to increasing health care access, reducing costs, and improving health care quality and outcomes. One promising model is expanding paramedic roles to include non- emergency home visits to patients. Employing a comparative case study, this paper describes three Emergency Medical Services (EMS)- based care coordination programs that provide services to rural, underserved patients, who frequently use EMS/emergency departments. Across the three sites, four major themes emerged: (1) a shift in the paramedic and patient interactions from episodic, crisis- based to longer- term, ongoing relationships; (2) characteristics of rural context that both enabled and constrained paramedic care coordination programs; (3) impacts of care coordination including improvements in preventive care and disease self- management as well as peace of mind; and (4) concerns about programs’ sustainability. Emergency Medical Service- based care coordination appears to be a promising model for addressing the health and social needs of rural residents who frequently use EMS.

Original languageEnglish (US)
Pages (from-to)159-180
Number of pages22
JournalJournal of Health Care for the Poor and Underserved
Issue number4
StatePublished - Nov 2016


  • Care coordination
  • Care navigation
  • Emergency medical services
  • Frequent emergency department users
  • Rural health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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