Some trends in the delivery of ambulance services : Chaiken JM and Gladstone RJ (1974) Report R-1551, The Rand Corporation, 1700 Main Street, Santa Monica, California 90406, U.S.A.

Abstract

A composite description of present (1973) and planned emergency ambulance systems is provided based on information from 179 applicants to the Robert Wood Johnson Foundation for grants for regional emergency medical systems. The data indicate that only 11.1 percent of the ambulance services are now provided by funeral homes and 34.5 percent are provided by local government agencies. Local government agencies operate 28.9 percent of all emergency vehicles and volunteer agencies operate 19.2 percent. Most ambulance services are provided primarily by small agencies, with minimal coordination. A great deal of confusion surrounds telephone numbers for emergency services, but centralized systems are being initiated in a number of communities. Some obstacles remain to the installation of 911 emergency numbers across State or service boundaries. The advantages and disadvantages of a centralized command and control system of dispatching ambulances for several ambulance agencies are weighed and several configurations are proposed. Analysis of the time between dispatch of the ambulance and its arrival show a median of four minutes for urban areas and up to 25 minutes in rural areas. The 1973 level of ambulance attendant training shows that many areas depend on personnel with little or no training for providing initial emergency care. Training courses developed by the United States Department of Transportation for emergency medical technicians and dispatchers appear acceptable as reasonable goals for implementation within two years.