Department of Emergency Medicine, The Ohio State University, Columbus, Ohio.
Emergency Department, Rouen University Hospital, Rouen, France.
Prehosp Emerg Care. 2023;27(4):432-438. doi: 10.1080/10903127.2022.2103757. Epub 2022 Aug 29.
Emergency medical services (EMS) play a key role in access to prehospital emergency care. While EMS has defined levels of certification, the roles in the care paradigm fulfilled by these clinicians vary. The aim of this study is to describe the national differences between EMS clinicians with primary non-patient care vs. patient care roles.
We performed a cross sectional evaluation of nationally certified EMS clinicians in the United States who recertified in 2020. As part of the recertification process, applicants voluntarily complete profile questions regarding demographic, job, and service characteristics. We compared the characteristics between individuals self-reporting primary patient care roles vs. non-patient care roles. Using logistic regression, we determined independent predictors for having a non-patient care role.
In 2020, 126,038 people completed recertification. Of the 96,661 completing the profile, 80,591 (83.4%) indicated that they provided patient care, and 16,070 (16.6%) did not provide patient care as a primary role. Non-patient care personnel were more likely to be older (median 43 years old vs 34 years old), and to have a higher level of education (bachelor's degree or more: OR 2.25, 95%CI [2.13-2.38]) compared with patient care practitioners. Non-patient care personnel were less likely to be female (0.67 [0.64-0.70]) and minorities (OR 0.80 [0.76-0.84]). Non-patient care personnel reported longer work experience (16 years or more: OR 6.30 [5.98-6.64]), were less likely to hold part time positions (OR 0.62 [0.59-0.65]), and were less often attached to more than one agency (OR 0.83 [0.79-0.86]). Non-patient care personnel were less likely to work in rural settings (OR 0.81 [0.78-0.85]).
EMS clinicians in non-patient care roles account for 17% of the study population. The odds of performing as a non-patient care practitioner are associated with characteristics related to demographics and workforce experience. Future work will be necessary to identify mechanisms to encourage diversity within the patient care and non-patient care workforces.
急救医疗服务（EMS）在获得院前急救方面发挥着关键作用。虽然 EMS 有明确的认证级别，但这些临床医生在护理模式中的角色有所不同。本研究的目的是描述美国 EMS 临床医生中主要从事非患者护理与患者护理角色的国家差异。
我们对 2020 年重新认证的美国全国认证的 EMS 临床医生进行了横断面评估。作为重新认证过程的一部分，申请人自愿完成关于人口统计学、工作和服务特征的个人资料问题。我们比较了报告主要患者护理角色与非患者护理角色的个体的特征。使用逻辑回归，我们确定了从事非患者护理角色的独立预测因素。
2020 年，有 126038 人完成了重新认证。在完成个人资料的 96661 人中，80591 人（83.4%）表示他们提供了患者护理，而 16070 人（16.6%）则不是主要角色。非患者护理人员更有可能年龄较大（中位数 43 岁比 34 岁），且受教育程度较高（学士学位或以上：比值比 2.25，95%CI [2.13-2.38]）。非患者护理人员中女性比例较低（0.67 [0.64-0.70]），少数民族比例也较低（比值比 0.80 [0.76-0.84]）。非患者护理人员报告的工作经验更长（16 年或以上：比值比 6.30 [5.98-6.64]），担任兼职的可能性较小（比值比 0.62 [0.59-0.65]），且很少同时隶属于多个机构（比值比 0.83 [0.79-0.86]）。非患者护理人员在农村地区工作的可能性较小（比值比 0.81 [0.78-0.85]）。
非患者护理角色的 EMS 临床医生占研究人群的 17%。从事非患者护理从业者的可能性与与人口统计学和劳动力经验相关的特征有关。未来需要开展更多工作，以确定在患者护理和非患者护理劳动力中鼓励多样性的机制。
