Projecting EMS Workforce Demand in an Aging State: A Florida Forecast Through 2035

OBJECTIVES: Population aging is a major contributor to increasing demand for emergency medical services (EMS), yet EMS workforce projections based on population data remain limited. This study projected future EMS incident volume and clinician workforce requirements in Florida from 2026 to 2035 based on historical data on EMS response records to inform workforce planning. METHODS: We conducted a retrospective, population-based secondary analysis and forecasting study using de-identified state-wide emergency EMS response records from Florida's Emergency Medical Services Tracking and Reporting System (EMSTARS) spanning January 1, 2017 through December 31, 2025. Incidents were assigned to seven age cohorts and aggregated into monthly time series. We used Seasonal Autoregressive Integrated Moving Average models with exogenous inputs (SARIMAX) to project age and cohort-specific incident volume for 2026 through 2035. Projected future incident volumes were translated into EMT and paramedic full-time equivalent (FTE) requirements using observed EMSTARS staffing configurations and target operational parameters. RESULTS: Annual EMS incidents increased from 4.10 million in 2017 to 5.22 million in 2025 and are projected to reach 7.76 million by 2035, a 48.8% increase over the 2025 baseline. By 2035, adults aged 60 and older are projected to represent 31.2% of Florida's population while accounting for 61.6% of all EMS incidents. Total estimated EMS workforce requirements are projected to increase from 9,542 FTEs in 2025 to 14,195 FTEs by 2035, requiring approximately 4,654 additional FTEs (a 48.8% increase). CONCLUSIONS: Florida's aging population is projected to drive a nearly 50% increase in EMS incident volume and associated workforce requirements over the next decade, with demand disproportionately concentrated among older adults. With a substantial concentration of adults aged 80 and older and a rapidly expanding oldest-old cohort, Florida is confronting the demographic conditions projected to emerge in other states over the next decade. The findings offer researchers and policymakers a replicable framework and a directly applicable planning reference for jurisdictions across the United States.