CARING FOR VULNERABLE POPULATIONS: ADDRESSING HEALTH DISPARITIES IN EMS WITH HEALTH ASSISTANCE TECHNICIANS

Abstract

It is well documented that the most common patient populations transported by Emergency Medical Services (EMS) are low-income, uninsured, or underinsured individuals, homeless people, and those with frequent contact with the ambulance service. Although transportation of these vulnerable populations comprises a majority of EMS encounters, they have a higher rate of no-transport decisions in urban 911 systems than rural EMS non-transport rates. An increasing body of evidence suggests these vulnerable populations also receive a lower level of care. The first section of the essay will present an overview of why there are disparities in patient care, a definition of these vulnerable populations, and health disparities. Following this will be a discussion of the roles and practices of Health Assistance Technicians in treating those patients. The case studies will identify how different models have been integrated with EMS and suggest future research and practices in this area.

EMS faces the challenge of integrating individuals who provide mental health and substance abuse services outside the conventional medical realm into health care systems. Health Assistance Technicians (HATs) were proposed in a limited capacity to serve as outreach workers to aid patients receiving care from primary response teams. The conclusion begins by enumerating the future research and models that will examine the financial impact of HAT services integration with EMS. Health disparities are pervasive in EMS. Integration of personnel to reduce disparities is warranted. EMS is ideally suited to treating non-urgent populations with high burdens of mental illness and substance addiction who are unlikely to seek care in primary care settings or are not acutely ill to necessitate emergency room care management.