A study involving four (4) rural emergency medical service systems in Kansas communities was undertaken to determine the feasibility of paramedic systems in small population base communities. The factors of skill deterioration and cost were measured since it is felt that these are the major detriments in establishing a paramedic system in a rural area. Each system was evaluated by number of emergency runs requiring advanced life support, the type of run, and the care given pre-hospital and in the emergency department. Skill deterioration and methods of maintaining EMT-P skills in such small communities were identified. The cost per capita of establishing and maintaining each system was also determined, along with the cost of lives saved in those patients presenting with a lethal arrhythmia.

The cost of lives saved was determined by multiplying the total cost of the system by the percent of patients presenting with a lethal arrhythmia and dividing this figure by the number of patients surviving a lethal arrhythmia. The time period for this particular portion of the study was one (1) year.