"The problems of health care in rural areas have long occupied a special niche in policies designed to advance the Nation's health. Programs for recruitment, training, and deployment of health care personnel, for constructing health care facilities, and for financing health care, often have included special provisions for rural areas. These programs have often also included attempts to mitigate the negative impacts on rural areas of policies primarily designed for and responsive to the needs of urban areas. [...] Mounting concerns related to rural residents' access to health care prompted the Senate Rural Health Caucus to request that OTA [Office of Technology Assessment] conduct an assessment of these and related issues. The first OTA paper prepared in connection with this assessment, 'Defining "Rural" Areas: Impacts on Health Care Policy and Research', was published in July 1989. This Special Report, 'Rural Emergency Medical Services', is the second paper prepared in connection with that assessment. This report finds that many State EMS [Emergency Medical Service] systems are fragmented and lacking resources to remedy EMS problems in rural areas. Many rural EMS programs lack specialized EMS providers, have inadequate EMS transportation and communications equipment, and are not part of a planned regional EMS system. The report describes the availability and distribution of emergency medical service (EMS) resources (e.g., personnel, transportation, facilities) and examines how limited Federal resources can be used to improve rural EMS. In addition, the report discusses how Federal EMS resources might be targeted to States' rural areas."
Office of Technology Assessment Special Report No. OTA-H-445