Ambulance Allocation and the Cost of Information Frictions in Emergency Care

Abstract Effective emergency medical response depends critically on accurate and timely allocation of scarce ambulance resources. This paper investigates the efficiency costs associated with informational frictions in the localization of patients during emergency calls. Using detailed administrative data from the Emergency Medical System of Liguria, Italy, I document systematic misallocations in ambulance dispatch, primarily driven by difficulties in pinpointing patient locations. Exploiting plausibly exogenous variation in call origin characteristics and dispatcher behavior, I estimate that localization frictions lead to substantial increases in response times, which in turn are correlated with adverse clinical outcomes. The analysis highlights the behavioral and organizational dimensions of emergency response systems, and quantifies the welfare implications of reducing information asymmetries in high-stakes public service delivery.