Is paramedic palliative care different in rural compared to urban settings: A mixed methods study.

This article examines differences in paramedic-provided palliative care between rural and urban settings in Nova Scotia, Canada, focusing on call characteristics, outcomes, challenges, and benefits. The "Paramedics Providing Palliative Care at Home Program" enables paramedics to deliver palliative support without mandatory emergency department transport, yet rural patients were more likely to be transported to hospital (72%) than urban patients (64%). Rural paramedics face unique challenges such as older, less accessible homes and limited local resources, while also serving as vital community connectors providing both medical and psychosocial support. The study highlights disparities in preparedness and access to services for rural patients and suggests that policy and practice should address these rural-specific needs to promote equitable palliative care at home.