Geographic Distribution of Accredited Paramedic Education Programs in the United States

Abstract

Background: The geographic distribution and access to paramedic education programs is unclear but often cited as a reason for emergency medical services (EMS) workforce shortages. Our aims were: 1) to examine the spatial distribution of accredited paramedic programs, and 2) to compare characteristics of communities with and without existing programs. Methods: We performed a cross-sectional study of US paramedic education programs accredited by the Commission on Accreditation of Allied Health Education Programs as of April 2020. Program locations were geocoded to county, and population estimates from the US Census Bureau were used to determine the adult population within the program's potential catchment area (30, 50, 100 miles). Clustering of programs was examined using Moran's I. We compared community characteristics obtained from the 2018 American Community Survey, 2018-2019 Area Health Resources Files, and 2018 National Emergency Department Inventory between counties with and without programs. Logistic regression models were used to determine associations of community characteristics and existence of a paramedic program, controlling for urbanicity. Results: There were 790 paramedic program locations in the US, located in 596/3142 (19%) counties. Every state, except Rhode Island and Washington, DC, had at least one paramedic program site. The population within potential catchment areas ranged from 182 million (30 miles) to 248 million (100 miles), representing 73% to 99% of the US adult population, respectively. However, among counties classified as rural (n=644), this decreased to 22% (30 miles) to 95% (100 miles). There was significant clustering of programs (p<0.001). There were significantly higher odds of having a paramedic program for counties classified as metro compared to non-metro (OR 4.42, 95% CI 3.60-5.42) and with the presence of healthcare resources (e.g., emergency department in the county: OR 2.42, 95% CI 1.87-3.14). Conclusions: Approximately 73% of the US adult population lives within 30 miles of an existing paramedic education program; however, this decreases to 22% in rural areas. Geographic barriers to accessing paramedic education remain a challenge for ongoing efforts to address the rural EMS workforce shortage.

Trends in demographic and employment characteristics of US emergency medical technicians and paramedics, 2011–2019

“…24 , 32 , 33 Regardless, paramedic education has largely transitioned to higher education settings (eg, community colleges) since the requirement for program accreditation began in 2013, and more than half of paramedic programs culminate in a 2‐ or 4‐year degree. 34 Many barriers to degree requirements persist, but educational attainment has been steadily increasing in EMTs and paramedics. If such degree requirements were instituted, about half of paramedics are estimated to have already obtained a 2‐year degree or higher, and an additional 40% have completed some college‐level coursework without earning a degree.…”

“…There has been recent controversy regarding required education for EMS personnel, such as a minimum requirement of an associate degree to become licensed or certified as a paramedic 24,32,33 . Regardless, paramedic education has largely transitioned to higher education settings (eg, community colleges) since the requirement for program accreditation began in 2013, and more than half of paramedic programs culminate in a 2‐ or 4‐year degree 34 . Many barriers to degree requirements persist, but educational attainment has been steadily increasing in EMTs and paramedics.…”

Effects of COVID-19 on EMS Refresher Course Completion and Delivery

“…9 Prior to COVID-19, several research studies had shown that improving access to initial education and CE impacts recruitment and retention of EMS professionals. 10,11,12 Even before the COVID-19 pandemic access to DL has been identified as a way to improve access to EMS education. 13,14…”

EMS Curriculum Should Educate Beyond a Technical Scope of Practice: Position Statement and Resource Document

“…35 Access to accredited paramedic programs remains geographically unequal; while 73% of the US population lives within 30 miles of an accredited paramedic training program, this decreases to 22% in rural areas. 36 Accreditation standards for paramedics discuss college credit; however, not all paramedic programs are linked directly to degree granting programs. Educational models in many locations remain technician/certification focused and do not mandate any additional college level courses as prerequisites.…”

“…37 Associate's degrees are more common among nationally registered paramedics than among AEMTs or EMTs (28.5% compared to 16%), and approximately half overall have academic degrees while an additional third have some college experience. 36 Two states (Kansas and Oregon) currently require an associate's degree at the paramedic level. 38 Texas recognizes paramedics with degrees and without degrees as separate designations: licensed paramedic for those with degrees and paramedic for those without.…”