Research Alert: August 16, 2023

A Consensus Panel Approach to Estimating the Start-Up and Annual Service Costs for Rural Ambulance Agencies

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services.

Key Findings:

• An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions.
• A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a second unit "on-call", supported by a chief.
• Based on this minimum access standard, the population density within an ambulance service area, and the expected run volume, the expert panel established three population-based service tiers and estimated corresponding start-up and annual service costs.
• Total annual budgets scale up from approximately $964,200 in 2020 dollars ($1.04 million in 2023 dollars) in low volume service areas (with as few as 25 responses per year) to $2.09 million in 2020 dollars ($2.25 million in 2023 dollars) in high volume service areas (with 1,500 - 2,200 responses per year).
• Breakeven analyses suggest that low volume agencies experience operating costs of approximately $41,500 (in 2023 dollars) per response, while high volume agencies experience operating costs of roughly $1,020 per response.

Additional Resources of Interest:

• Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
• More information about the Maine Rural Health Research Center
• More information from the Rural Health Information Hub's topic guides: EMS and Trauma, Transportation to Support Rural Healthcare