Ambulances binnen bereik. Analyse van de spreiding en beschikbaarheid van de ambulancezorg in Nederland
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Series / Report no.
Open Access
Type
Report
Language
nl
Date
2003-01-16
Research Projects
Organizational Units
Journal Issue
Title
Ambulances binnen bereik. Analyse van de spreiding
en beschikbaarheid van de ambulancezorg in Nederland
Translated Title
Availability of ambulance
services
Published in
Abstract
Het rapport Ambulances binnen bereik beschrijft de
resultaten van een landelijk onderzoek naar de geografische spreiding van
standplaatsen en de beschikbaarheid (capaciteit) van ambulances. Knelpunten
in de spreiding en beschikbaarheid uiten zich in het aantal keren dat een
ambulance niet binnen de norm van 15 minuten na melding op de plaats van
bestemming arriveert. In een tweetal scenario's worden mogelijkheden
verkend hoe door uitbreiding en verplaatsing van standplaatsen en
verandering van beschikbaarheid knelpunten in de voorziening van
ambulancezorg voor een deel kunnen worden opgelost. In 2001 vond bij 8,2%
(27.800) van het aantal spoedritten een overschrijding van de norm plaats.
Hoogstens 20% van de overschrijdingen waarvoor de rijtijd kon worden
bepaald, is het gevolg van ongunstige spreiding van ambulancestandplaatsen.
Hoe groot het effect van wijzigingen in de aard en omvang van beschikbare
ambulancecapaciteit zal zijn op het aantal overschrijdingen is niet te
zeggen. Daarvoor ontbreekt in de rittenregistraties van ambulances
informatie over de toedracht van overschrijdingen. Om dezelfde reden kunnen
de onderzoekers evenmin kwantificeren in hoeverre overschrijdingen worden
bepaald door nog andere factoren zoals de invloed van langere opstarttijden
bij piketdiensten en overmachtsituaties zoals verkeersopstoppingen en
-omleidingen, extreme weersopstandigheden of materiaalpech. Om
overschrijdingen en maatregelen in de toekomst beter te kunnen evalueren
doen de onderzoekers de aanbeveling om de kwaliteit van de
rittenregistraties en de registratiewijze in de ambulancezorg te
verhogen.
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.
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.
Description
Publisher
Adviesbureau W.F. Botter
Sponsors
VWS