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Examining the alignment between an intervention-based paramedic model of care and 9-1-1 utilization.
Walter Tavares1,2,3,4, Ryan P Strum5,6,7, Lindsay Henderson5,8
1Department of Health and Society, Wilson Centre for Health Professions Education Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. walter.tavares@utoronto.ca.
BMC Health Services Research
|June 10, 2026
Summary
Paramedic care models often don't align with public 9-1-1 use. Most calls involve non-emergency events, with the current intervention-based model applied in less than 20% of cases, suggesting a need for system redesign.
Area of Science:
- Emergency medicine
- Health services research
- Public health policy
Background:
- Paramedic services traditionally focus on emergencies and transport.
- Increasing non-emergent calls may indicate a mismatch with the current paramedic model of care.
- Public health services must adapt to evolving community needs.
Purpose of the Study:
- To evaluate the alignment between the existing paramedic model of care and public health requirements.
- To assess how paramedic interventions correspond with 9-1-1 utilization patterns.
Main Methods:
- Retrospective observational cohort study of 1,244,537 patient interactions from Ontario, Canada (2017-2023).
- Analysis of electronic patient care records against the Advanced Life Support Patient Care Standards.
- Descriptive and inferential statistics to explore alignment between care models and patient acuity.
Main Results:
- Only 20% of incidents utilized the existing intervention-based model of care.
- Intervention use decreased significantly with lower patient acuity.
- 9-1-1 system use was primarily for non-emergency events, not aligning with the current model.
Conclusions:
- Limited correspondence exists between the current paramedic model and 9-1-1 utilization patterns.
- The intervention-based model is applied in a minority of patient encounters.
- Existing paramedic system paradigms may require reconsideration or augmentation.
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