Air or Ground EMS: The Fastest Route to Care in Alberta

Emergency medical response is complex. The need to make time-based decisions that can impact people’s health requires careful examination. Network analysis, among other methods, can support that time-based decision making. This study explores network analysis through a multi-modal transportation network model to represent both fixed-wing air and ground Emergency Medical Services (EMS) resources. Methods: The study utilized open and EMS industry data to build a geospatial multi-modal network to model potential patient transfer across Alberta (Canada). Results: Within the study’s service area, ground transportation alone is more effective within 101 Km, at which threshold the addition of aerial transport begins to be more time effective, saving 9.7 min over ground transportation only. Between this distance and 417 Km, results show a mixed-use area where a combination of ground only and aerial travel is recommended based on the event pickup location, aircraft availability, and ambulance station location relative to high-speed roads. Beyond 417 Km, aerial transportation is consistently more efficient. There is a high correlation (R2 = 0.82) between trip length and time difference between using ground only mode and combined air and ground. Lastly, the data showed air travel is 6.6 times more expensive than ground travel, with no modeled transfers identifying air as more time-effective than ground travel. Conclusions: Fixed-wing aircraft travel can have a positive impact on patient transfers; however, fluctuations in flight routes and times may require response agencies to implement time buffers to account for these variabilities. No cost savings were seen using fixed-wing aircraft, and the benefit of their use would be realized with efficient patient transfer times, as well as leaving ground ambulances in localized areas.