Ambulances binnen bereik. Analyse van de spreiding enbeschikbaarheid van de ambulancezorg in Nederland

In the Dutch emergency care in 2001 about 8.2% of the ambulance services exceeded the standard 15 minutes response time, or 13 minutes actual travel time. This report identifies possibilities for improved availability of ambulance services. Two scenarios were developed explore ways of increasing this coverage. In the first scenario, ambulance posts are added to the present set. In the second scenario a number of existing posts are moved to more optimal positions whereafter posts were added. At present, a theoretical 93% of the Dutch population can be reached within 13 minutes driving time from the existing 195 ambulance posts. In the first scenario this coverage is improved to 95% by adding 15 posts; 97% coverage is achieved with a total 235 posts. In the second scenario, we show that by moving 50 posts the coverage can already be increased to almost 95%. The capacity model determined that, compared to the current situation, the capacity needed to meet the demand for ambulances ranges from 10% less in the minimum variant to 9% more in the maximum variant. An improved spatial coverage can be accomplished by adding new and/or relocating current posts. This improved distribution will solve the response-time failures for 21% at the most, however. Furthermore, increasing the capacity of ambulances in selected regions may contribute to a further decrease in response-time failures. If ambulance services would make more use of 'mobile availability', the number of failures could decrease even more. Yet, mobile availability is not an option for all regions. The quality of the currently available data on Dutch ambulance performance limits the interpretation of our modelling results. Although the model provides directions for solving the distribution problems, the data and methods do not allow to draw detailed conclusions on allocation or reallocation of ambulances.