{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T22:02:30Z","timestamp":1761948150706},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2012,6,28]],"date-time":"2012-06-28T00:00:00Z","timestamp":1340841600000},"content-version":"unspecified","delay-in-days":5598,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[1997,3]]},"abstract":"Abstract<\/jats:title>Introduction:<\/jats:bold><\/jats:title>Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, \u201cIt is not government's obligation to provide services, but to see that they're provided.\u201d Even in the area of public safety, privatization has found a \u201cmarket.\u201d<\/jats:p>In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9\u20131\u20131 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this \u201ccontracting-out\u201d model has many benefits.<\/jats:p>Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service.<\/jats:p>The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can be fostered.<\/jats:p>The purpose of this paper is to present several important concepts and considerations that public officials, medical directors, and the public must be aware of when contemplating the possibility of privatizing their Emergency Medical Services. A review of the general concepts of privatization and issues of accountability will be presented, referencing policy experts, followed by an examination of how advocates of privatization might see these issues as they relate to providing EMS. The conclusion will present prescriptions for both municipal and commercial ambulance providers.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1049023x00037171","type":"journal-article","created":{"date-parts":[[2016,7,17]],"date-time":"2016-07-17T22:55:50Z","timestamp":1468796150000},"page":"22-29","source":"Crossref","is-referenced-by-count":3,"title":["Privatization and Emergency Medical Services"],"prefix":"10.1017","volume":"12","author":[{"given":"Stephan G.","family":"Reissman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2012,6,28]]},"reference":[{"key":"S1049023X00037171_ref012","volume-title":"Prospects for Privatization","author":"Hanke","year":"1987"},{"key":"S1049023X00037171_ref015","volume-title":"Revitalizing State and Local Public Service","author":"Chapa","year":"1993"},{"key":"S1049023X00037171_ref020","volume-title":"Prehospital Systems and Medical Oversight","author":"Stout","year":"1994"},{"key":"S1049023X00037171_ref021","volume-title":"PreHospital Care: Administrative and Clinical Management","author":"Drake","year":"1987"},{"key":"S1049023X00037171_ref002","volume-title":"The Public Administration Dictionary","author":"Chandler","year":"1988"},{"key":"S1049023X00037171_ref014","volume-title":"Managing Public Programs: Balancing Politics, Administration and Public Needs","author":"Cleary","year":"1989"},{"key":"S1049023X00037171_ref017","volume-title":"Breaking Through Bureaucracy","author":"Barzelay","year":"1992"},{"key":"S1049023X00037171_ref024","volume-title":"Prehospital Systems and Medical Oversight","author":"Fowler","year":"1994"},{"key":"S1049023X00037171_ref019","volume-title":"Privatization","author":"Kemp","year":"1991"},{"key":"S1049023X00037171_ref018","volume-title":"Privatization in America: An Opinion Survey of City and County Governments on Their Use of Privatization and Their Infrastructure Needs","year":"1987"},{"key":"S1049023X00037171_ref023","first-page":"54","article-title":"The public\/private interface","volume":"7","author":"Stout","year":"1983","journal-title":"Journal of Emergency Medical Services"},{"key":"S1049023X00037171_ref007","volume-title":"The Privatization Revolution","author":"MacNamara","year":"1987"},{"key":"S1049023X00037171_ref010","volume-title":"Government and the Private Sector: Who Should Do What","author":"Ross","year":"1988"},{"key":"S1049023X00037171_ref025","volume-title":"This Way Up: The Local Official's Handbook for Privatization and Contracting Out","author":"Armington","year":"1984"},{"key":"S1049023X00037171_ref003","volume-title":"When Government Goes Private: Successful Alternatives to Public Services","author":"Fitzgerald","year":"1988"},{"key":"S1049023X00037171_ref005","volume-title":"The Privatization Decision","author":"Donahue","year":"1989"},{"key":"S1049023X00037171_ref006","unstructured":"6. President's Commission on Privatization: Privatization: Toward More Effective Government. 1988."},{"key":"S1049023X00037171_ref004","volume-title":"Contracting Out in Government","author":"Rehfuss","year":"1989"},{"key":"S1049023X00037171_ref026","first-page":"76","article-title":"EMS in the United States: 1995 survey of providers in the 200 most populous cities","volume":"20","author":"Cady","year":"1995","journal-title":"Journal of Emergency Medical Services"},{"key":"S1049023X00037171_ref008","volume-title":"Alternatives for Delivering Public Services","author":"Savas","year":"1977"},{"key":"S1049023X00037171_ref022","volume-title":"Continuous Quality Improvement in EMS","author":"Polsky","year":"1992"},{"key":"S1049023X00037171_ref011","volume-title":"Privatization","author":"Goodman","year":"1985"},{"key":"S1049023X00037171_ref009","volume-title":"Organization Theory and Public Organizations","author":"Heffron","year":"1989"},{"key":"S1049023X00037171_ref013","volume-title":"Public Sector Privatization","author":"Finely","year":"1989"},{"key":"S1049023X00037171_ref001","volume-title":"Reinventing Government","author":"Osborne","year":"1992"},{"key":"S1049023X00037171_ref016","volume-title":"Revitalizing State and Local Public Service","author":"Kettl","year":"1993"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X00037171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,11]],"date-time":"2019-05-11T17:21:02Z","timestamp":1557595262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X00037171\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,3]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1997,3]]}},"alternative-id":["S1049023X00037171"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x00037171","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,3]]}}}