Congratulations goes out to Dr. Megumi Sakamoto who successfully defended her dissertation titled "Cashing in on Medical Emergencies: Assessment of Emergency Medical Services Profit Status and Its Effects on Population Health Outcomes." Dr. Sakamoto is advised by Dr. Ernesto Amaral, her committee members include Dr. Mary Campbell, Dr. Harland Prechel, and Dr. Daikwon Han (School of Public Health).
Emergency Medical Services (EMS) is one of the most vital systems that provides communities health services by attending to medical emergencies and providing life support, triage, and patient transportation. Although EMS has been recognized as a part of public health services since 1973, it has been commonly excluded from health disparities research. Literature suggests that social determinants of health, such as socioeconomic status, race/ethnicity, and rurality may affect the accessibility of EMS. In addition, EMS organization types, such as public or private, may influence its impact on population health outcomes at the community level because the “social cost” of keeping the population healthy may not be prioritized over the organizational survival especially by private EMS.
This three-fold dissertation examined the following: (1) EMS agencies’ organizational behaviors, (2) EMS’s impact on mortality in Texas, and (3) EMS’s impact on COVID-19 mortality in Texas. The results from analyses using National EMS Information System found that private EMS agencies tend to be less involved in civil services including 9-1-1 transportation compared to public EMS, and they also take patients with insurance, government assistance, or facility payment more than self-paid patients. Exploratory spatial analyses revealed that EMS agencies are clustered in large cities in Texas, while North and East Texas have low EMS vehicles-to-population ratio.
The results of spatial analyses concluded that while overall EMS vehicles-to-population ratio had negative direct effects on mortality rates of all causes and injury and heart disease, it is only accredited to government-owned EMS when the EMS types were disaggregated. The results of spatial panel analyses found similar results; the high ratio of government EMS vehicles to the total EMS vehicles had negative direct effects on the COVID-19 mortality, however, the association was sparse for for-profit EMS vehicles. Overall, the findings concluded that EMS contributes to population health outcomes though the magnitude varies by their organization type. Dr. Sakamoto concluded that EMS are significant parts of health care resources which would be a valuable factor to include in social determinants of health measures. The findings confirmed that the funding sources of health care delivery make a difference in health outcomes.
Congratulations, Dr. Megumi Sakamoto!