The role of hospital selection in ambulance logistics

Response time in emergency medical service is the time taken to reach patient after an emergency call is received, and it directly affects the welfare and safety of patients. An ambulance dispatched to a call serves patient on site and, if it is necessary to transfer to an emergency department (ED), a decision has to be made in selecting an appropriate hospital. The hospital selection is closely associated with the response time especially by influencing the availability of ambulances. The hospital selection problem is getting increasingly important because of the crowding problems EDs are struggling with. In this research, the impact of various hospital selection policies (including the diversion policy popularly used in practice) on response time is systematically investigated and a novel hospital selection policy—3C policy—is proposed that integrates three decision principles of closeness, congestion, and centrality. The experimental results demonstrate that the proposed policy significantly and robustly outperforms other policies, e.g. reducing response time by up to 90% over diversion policy. The 3C policy emphasizes the critical role that networking and information technology will play in measuring and communicating information associated with the policy.