Improving rural emergency medical services (EMS) through transportation system enhancements.

Samra, Haifa; Qin, Xiao; He, Zhaoxiang · 2014 · ROSA P / Mountain Plains Consortium

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Summary

This study addresses the critical need to improve emergency medical services (EMS) in rural South Dakota, where long travel distances and sparse infrastructure contribute to higher unintentional mortality rates compared to urban areas. The research was motivated by the disparity in EMS performance between rural and urban settings and the high fatality rates associated with delayed care. The primary goal was to identify issues affecting the delivery of quality EMS to rural residents and conduct a needs assessment from a transportation system perspective. Specifically, the researchers aimed to identify service needs in rural communities, evaluate transportation components supporting swift and safe EMS, and identify issues faced by providers regarding roads and traffic controls. The methodology combined quantitative analysis of EMS data with qualitative input from personnel. The researchers analyzed a subset of 50,396 EMS records from the National EMS Information System (NEMSIS) for the year 2012, focusing on 15,140 valid 911 responses. Spatial and temporal analyses were conducted using GIS mapping and descriptive statistics to examine demand patterns and performance metrics, including response time, en-route time, on-scene time, and transporting time. Additionally, surveys and focus groups with EMS personnel were conducted to identify operational challenges. Key findings revealed significant disparities between urban and rural EMS performance. Rural en-route and transporting times were nearly double those in urban areas, with rural ambulances traveling significantly longer distances (7.29 miles to scene vs. 2.26 miles in urban areas) at higher speeds (39.36 mph vs. 28.04 mph). Spatial analysis identified Todd County as having the highest demand, while Harding County exhibited the longest overall response times. Temporal analysis showed peak demand during summer months and weekends, with hourly peaks between 11 am–2 pm and 4 pm–6 pm. The study also found that travel distance was the dominant factor affecting performance in rural areas, and that nighttime transporting speeds were significantly lower than daytime speeds. Qualitative data highlighted factors leading to delays, including road conditions and traffic controls. The significance of this research lies in its identification of specific gaps in rural EMS infrastructure and performance. The findings suggest that enhancing roadway networks and optimizing the placement of EMS stations and hospitals are crucial for reducing response times in rural South Dakota. By providing a detailed assessment of service demand and transportation system components, the study offers evidence-based recommendations for improving traffic safety and public health outcomes in rural communities. The results underscore the need for targeted interventions in sparsely covered central regions and highlight the importance of considering transportation infrastructure in EMS planning to ensure timely access to definitive care.

Key finding

Rural en-route times were nearly double those in urban areas, averaging 8.87 minutes compared to 4.60 minutes, with travel distance identified as the primary determinant of EMS performance.

Methodology

dataset

Sample size: 15140

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

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• post crash care delays