Community Paramedics' Perception of Frequent ED Users and the Community Paramedicine Program: A Mixed-Methods Study.

Community paramedicine (CP) model of care integrates existing emergency medical service (EMS) resources with primary care, public health, social services and community engagement. However, published studies about CP programs in the U.S. are sparse. To understand how paramedics perceive CP programs and patients in the program, we surveyed and interviewed 16 community paramedics (10 men and 6 women) who are currently delivering health care within a CP program. Our analyses highlighted that community paramedics: (1) defined CP patients in sympathetic terms; (2) reported patient and systemic factors contributing to ED overuse; and (3) expressed their frustrations and commendations for CP programs. Several suggestions were identified to improve CP program (all modifiable elements). Further, the frustrations expressed by paramedics highlight the barriers to health care access for underserved communities. We discuss the implications of this research for practice and recommend future qualitative studies on longer operating CP programs.