First, although RMPs were created for heart disease, cancer, and stroke, national RMP leaders felt that they had to provide a “much wider range of services, and did that.” 18 Second, RMP funding was through grants and not through categorical federal programs. 14 – 17įive RMP characteristics were important. 7, 12 These recommendations, reminiscent of the final report of the Committee on the Costs of Medical Care, 13 resulted in the Regional Medical Programs (RMP). Another recommendation was that the government work to ensure the proper dissemination of medical advances, and to translate research advances to benefit the health of the population. Among the 35 conclusions was a recommendation that the government assist in establishing regional associations centered around academic medical centers to improve research, education, and patient care. ” 7 (p88) The resulting report developed a plan to attack these diseases and to improve the national capabilities for scientific advancement and for providing medical services. there is no other that really offers more and greater hope. we are interested in the food stamp plan. In 1964, President Johnson asked DeBakey and others to develop a program to conquer heart disease, cancer, and stroke. 9 This “crisis” was occurring despite advances in trauma care that had reduced the mortality rate for injured soldiers reaching medical facilities from 4.5% during World War II to less than 2% during Vietnam. 8 By 1965, Congressional leaders noted the large and rapidly increasing health and financial cost of trauma. 4, 6 Second, trauma was identified as a public health “crisis.” In 1960, President Kennedy announced that traffic accidents in the United States were a major public health problem needing attention. First, treatment of cardiovascular disease and cancer had significant public interest and support because Mary Lasker and other social and medical activists had fought to expand research on these diseases. ” 7 Three other factors were also involved. President Lyndon Johnson announced in his Health Message in 1964 that “two thirds of Americans now living will.
6 However, these clinical conditions continued to receive significant attention, and the treatment of heart disease and cancer, as well as trauma and stroke, would later become central to the argument for improving the EMS system.Ī major reason for the deep interest in cancer, heart disease, stroke, and trauma was the perception that they formed the majority of the public health burden. The report was to have been presented on April 17, 1961, but it was “lost” in the furor surrounding the Bay of Pigs invasion and never presented to President Kennedy. 5 Following the common belief in post–World War II United States that funding for scientific and technological advances would lead to improvements in health, 4 President Kennedy empanelled a commission chaired by Michael DeBakey to improve the care of patients with heart disease and cancer. In 1960, treating heart disease and cancer were of such interest that the need for a government-sponsored program to cure them appeared in the 1960 Democratic Party platform.
2 Despite the major expansion in health care facilities and the emphasis on medical specialization after World War II, the EMS system had not received much attention or innovation. Physicians staffed some ambulances, while others had minimally trained or untrained personnel. By 1960, a patchwork of unregulated systems had developed, with services sometimes being provided by hospitals, fire departments, volunteer groups, or undertakers. 2 Lessons learned during the Civil War were applied as civilian EMS systems formed during the late 1800s. 1 During the Civil War, the Union Army developed an organized system to evacuate soldiers from the field. Modern EMS is considered to have started with Jean Dominique Larrey, Napoleon’s chief physician, who organized a system to treat and transport injured French soldiers. These forces have had a tremendous impact on the structure and functioning of the EMS system, resulting in profound public health implications today. Between 19, a number of medical, historical, and social forces converged, leading to the development of a more structured EMS system in the United States. Although modern EMS initially developed during Napoleon’s time to aid injured soldiers, 1 few major changes occurred in EMS until the 1960s. THE EVOLUTION OF THE emergency medical services (EMS) system has been a slow process.
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