a1 Office of Quality and Patient Safety, University of New Mexico Hospitals and Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico USA
American Emergency Medical Services (EMS) agencies largely have been untouched by the dramatic health care reform efforts underway, although change seems imminent. Clarifying the role of the modern EMS system, and the yardsticks used to evaluate its performance, will be a challenge.
This paper introduces the concept of value (or outcomes to cost ratio) in EMS, and offers value assessment as a means by which reform decisions can be framed. The best reform decisions are those that optimize both costs and outcomes. This includes: (1) attention to the patient experience; (2) disallowing the provision of unhelpful, harmful or disproven prehospital care; and (3) expanding patient dispositions beyond Emergency Departments. Costs of care will need to be tracked carefully and acknowledged. Value generation should serve as the goal of ongoing EMS reform efforts.
Munk MD. Value generation and health reform in emergency medical services. Prehosp Disaster Med. 2012;27(2):1-4.
(Received January 27 2012)
(Accepted March 25 2012)
Conflicts of interest: None