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A total of $22 million was appropriated between 1974 and 1979 for EMS research. The National Center for Health Services Research, in coordination with DHEW, funded various clinical and systems research projects. During the 1979 legislative hearings, testimony from DHEW and the leadership of academic research centers stressed the need for continued EMS research. Annual reports from DHEW detailed the types of research under way, the questions being studied, and the scope of long‐term and short‐term research projects funded under Section 1205 of Title XII [51]. These projects included “methods to measure the performance of EMS personnel, evaluate the benefits and the costs of ALS systems, examine the impact of categorization efforts, determine the clinical significance of response time, and explore the consequences of alternative system configurations and procedures” [56]. Other projects focused on “developing systems of quality assurance, designing and testing clinical algorithms, and examining the relationships between emergency departments and their parent hospitals (including rural‐urban differences)” [56].

In early 1979, the Center for the Study of Emergency Health Services at the University of Pennsylvania urged continued support of EMS research. It claimed, “Dollars spent in EMS research have great potential to help control rising health care costs, [and can] have a significant and visible effect in preventing death and enhancing the quality of patient life following emergency events” [57]. The center suggested research identifying EMS cost control potentials because the phasing out of federal funds, coupled with the effects of local tax revolts, would certainly reduce financing. As the 1980s progressed, the demand for more efficient, effective systems would become universal. Managers of EMS systems, just like their counterparts elsewhere, needed to know which components of the system were crucial and which could be deleted if funding was limited. The answers to those questions were anything but clear.