Paramedics bridge medical care and community support, study finds
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A research group led by Dr. Keiko Ueno, assistant professor at the Innovative Clinical Research Center, Kanazawa University, has revealed the status of collaboration between fire-based emergency medical service (EMS) agencies and community-based long-term care, welfare , and health organizations in Japan. The study identified six key practical measures essential for building a collaborative model that sustains long-term coordination between medical care and social support needs.
As population aging accelerates in Japan, the health and social issues experienced by community residents are becoming increasingly complex. Prehospital emergency care is now expected to go beyond conventional lifesaving and patient transport functions, playing a critical role in bridging medical care and community support—particularly in areas such as social isolation and difficulties accessing care services.
To examine the status of collaboration between EMS agencies and local care systems, the research team conducted semi-structured interviews with 26 paramedics from 20 fire departments nationwide. The findings demonstrate that such collaboration contributes to more efficient response operations, enhanced mutual understanding across professions, and more appropriate ambulance use. At the same time, ambiguities in coordination structures, limited staffing capacity, and barriers to information sharing emerged as major challenges. Furthermore, the study identified six practical strategies that can support sustainable interorganizational collaboration.
This research is expected to contribute to the development of a new support model that integrates prehospital emergency care with community-based integrated care systems.
The results were published in the journal Prehospital Emergency Care on Dec. 8, 2025.
As the complexity of health and social issues faced by community residents increases, prehospital emergency care is required to respond not only to acute, life-threatening conditions but also to social determinants of health, such as social isolation and barriers to accessing welfare services. In Japan, fire departments have implemented various approaches to assist individuals requiring social support—such as people living alone, those with chronic illness, or frequent EMS users—and to mitigate challenges related to hospital acceptance.
However, evidence regarding practical experiences, benefits and challenges of collaboration between fire-based EMS agencies and community long-term care, welfare, and health organizations has been limited. This study used qualitative interviews*7) to explore the benefits, challenges and sustainability strategies related to collaboration.
Semi-structured interviews were conducted with 26 paramedics affiliated with 20 fire-based EMS agencies across Japan between October and December 2023. A qualitative descriptive approach identified the following:
Benefits of collaboration:
- More efficient and flexible EMS response
- Improved interorganizational communication and mutual understanding
- Promotion of appropriate ambulance use through timely referral to community resources
Challenges to collaboration:
- Ambiguity in interorganizational collaboration and coordination
- Limitations in the operational capacity of relevant organizations
- Insufficient interprofessional understanding and collaborative attitudes
- Limited access to patient information from community organizations
- Need to protect personal information
Six practical measures for sustainable collaboration:
- Promotion of relationship building and mutual understanding
- Establishment of a sustainable interorganizational collaboration framework
- Interorganizational information-sharing infrastructure
- Clarification of the roles and response policies of fire-based EMS agencies
- Enhancement of interprofessional understanding and educational opportunities
- Securing human resources in long-term care and welfare organizations
This study provides foundational insights for building a collaborative support model that integrates prehospital emergency care with community-based comprehensive care. Moving forward, the researchers will continue to incorporate perspectives from health care, welfare and community stakeholders to develop feasible systems for real-world implementation.
More information
Keiko Ueno et al, Exploring Positive Experiences, Challenges, and Sustainability Measures in Inter-Organizational Collaboration: A Qualitative Study of Fire-Based Emergency Medical Service Agencies in Japan, Prehospital Emergency Care (2026). DOI: 10.1080/10903127.2025.2598562
Key medical concepts
Social Determinants of HealthSocial IsolationChronic Disease
Clinical categories
Emergency medicineHealthy aging Provided by Kanazawa University Who's behind this story?
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