Evaluating Emergency Medical Services

Abstract

The need to evaluate expensive, dramatic, and politically sensitive emergency medical services programs when classical controlled trials are neither ethically nor practically possible can be satisfied by quasi-experimental designs. The sequential implemen tation of paramedic services in several suburban areas provided a natural experimental situation in which to evaluate whether addition of the service could significantly alter the outcome of cardiac emergencies compared to the basic emergency medical technician program previously available. Before measurements and after measurements were made in a study area plus two control areas: one with paramedic services in both time periods and the other with emergency medical technican service throughout. Preliminary results indicate successful resuscitation increased from 20% to 32% (p < .05) and discharge from the hospital went from 8% to 18% (p<.01). The implications for program and policy decisions are noted. Development of studies that evolved from this work are outlined