Preclinical emergency medical services in Germany (EMSiG)

In the German sector of EMS, paramedical services are supplemented by physician services. The whole country is divided in “rescue districts”, typically identical with one or more counties. In contrast to other European countries, there are no stringent nationwide regulations for this sector. As a result, legal definitions (e.g. legal requirements for availability) and actual practice vary substantially between and within the federal states and the rescue districts. In addition, different criteria apply for resource planning (Schmiedel 2004), which are based on demographic and geographic characteristics and/or result from simulations of needs. We thus observe a huge variety of organizational forms and supply of EMS which can be interpreted as different EMS health care systems in terms of qualifications and competences of paramedic staff, types and forms of providers, technical equipment of these services and resource planning (i.e. organizational forms).

The project is structured as follows:

• Structures, costs and capability of EMS

• EMS and Health Outcomes

• Preferences for EMS and responsiveness

• Substitution effects  between ambulatory and hospital emergency
  

• Explanatory approaches for the increasing number of emergency hospitalization