Application of evidence-based practice is making a difference in the 200 largest cities in the United States. A November 2013 study commission by the U.S. Conference of Mayors shows that a third of the metropolitan areas will record flat or negative economic growth.1 Only 2% of the metros will record an annual growth exceeding 2% in real gross metropolitan product.2 Despite this struggling economy, however, EMS agencies in the most-populous U.S. cities are continuing to improve patient care.
About the Data
The leaders of the first-responder and transport agencies (n=512) serving the 200 most populous cities in the U.S. were invited to participate in the 2013 JEMS 200 City Survey via email. Conducted online, the survey included 75 questions. Many questions asked for multiple pieces of data. The completed survey response rate was 14.8% (n=76). Some of the 17 incomplete surveys provided many—but not all—answers, and were included in the data when appropriate. Table 1 provides the details.
This year’s respondents to the JEMS 200 City Survey included more participation from the 15 largest cities. This may affect some of the results. For example, only 36.9% of first responders provided paramedic service (31 out of 84). Previous surveys showed as many as half of the first responders providing paramedic service.
The survey covered a variety of EMS topics: dispatch, first response, transport, medical direction, performance measurement, effect of the economy and system funding. Much of the information shared isn’t publicly accessible and, in many cases, is proprietary. Every effort has been made to protect the privacy of the respondents. All data is discussed in aggregate and doesn’t indicate individual cities or EMS organizations.
Although accuracy is a key aim, this isn’t a scientific report, and the findings and conclusions haven’t been peer-reviewed. The results are dependent on the quality of the data received, as is the case with all research projects. All completed surveys were included in the data analysis. In many instances, data weren’t available or relevant for all respondents and a smaller sampling is indicated. Some questions also asked respondents to “check all that apply,” and as a result, the responses totaled greater than 100%.
1. The United States Conference of Mayors (November 2013.) U.S. metro economies: Outlook—gross metropolitan product, with metro employment projections. IHS Global Insight. Retrieved Dec. 4, 2013, from www.usmayors.org/metroeconomies/2013/ 201311-report.pdf.
2. Maciag M. (Nov. 19, 2013.) Gross metropolitan product slows in 2013, report finds. Governing. Retrieved Dec. 4, 2013, from www.governing.com/news/headlines/gross-metropolitan-product-slowdown-for-2013-2014-projections.html.