Can EMS Keep up With Our Aging Population?

According to the World Health Organization, the world’s population is rapidly aging. Between 2000 and 2050, the proportion of the population over 60 years will double from roughly 11% to 22%. The number of people aged 60 years and over is expected to increase from 605 million to 2 billion over the same time period.

I have been in EMS for a good part of my career and am quite familiar with the impact these demographics can have on call volume. This article, that cites how “Toronto EMS is overwhelmed and understaffed,” makes me wonder if their experience is the future of EMS.

EMS administrators need to plan their unit staffing to account for an increase in people confined to nursing homes, assisted living centers, and within the home. While the aging population is a global event, in the United States the issue becomes even more complex with recent health care reforms. There may be a greater shift to paying for outcomes, instead of paying a fee for service. Historically, EMS has done a poor job of building, measuring and adjusting service delivery outcomes based upon science and data. Health care reform could have a dramatic affect on reimbursement without progressive thinking by EMS administrators.

However, I think there is an opportunity for EMS to evolve to a more sophisticated model of caring for patients outside of a hospital. This could include transport facilities other than hospital emergency departments, or expanding the scope and practice of paramedics to include more non-emergency treatment.

The challenge is to develop new models for EMS that will meet increased 9-1-1 demands from an aging population as well as requirements for nontraditional care due to health care reform. There are many variables in this equation, and I wonder if we will see EMS agencies forced out of business — particularly those operated by volunteers or those primarily doing inter-facility transports.

I’m curious, are readers optimistic or pessimistic about the future of EMS currently serving their community? And why? Please share your thoughts.