Community paramedicine: cost–benefit analysis and safety evaluation in paramedical emergency services in rural areas – a scoping review

OBJECTIVE: To examine the current knowledge and possibly identify gaps in the knowledge base for cost–benefit analysis and safety concerning community paramedicine in rural areas. DESIGN: Scoping review. DATA SOURCES: MEDLINE via PubMed, CINAHL, Cochrane and Embase up to December 2020. STUDY SELECTION: All English studies involving community paramedicine in rural areas, which include cost–benefit analysis or safety evaluation. DATA EXTRACTION: This scoping review follows the methodology developed by Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We systematically searched for all types of studies in the databases and the reference lists of key studies to identify studies for inclusion. The selection process was in two steps. First, two reviewers independently screened 2309 identified articles for title and abstracts and second performed a full-text review of 24 eligible studies for inclusion. RESULTS: Three articles met the inclusion criteria concerning cost–benefit analysis, two from Canada and one from USA. No articles met the inclusion criteria for safety evaluation. CONCLUSION: There are knowledge gaps concerning safety evaluation of community paramedicine in rural areas. Three articles were included in this scoping review concerning cost–benefit analysis, two of them showing positive cost-effectiveness with community paramedicine in rural areas.