Regulation of ambulance response times in California

To identify regulatory programs for ambulance response times used by California counties, to inventory their foci and application, and to identify differences around the state. By studying the variety of programs used in one state, this study establishes a framework for evaluation of state and local regulatory programs elsewhere.

This study surveyed all California local EMS agencies (LEMSAs), California's equivalent of regional EMS organizations. The survey achieved a 100% response rate and all data involve population parameters obviating the need for inferential statistics.

Fifty-seven percent of California counties regulate response times. Large-population counties and those that operate their own LEMSAs are more likely to use response time regulations than are small counties and those that participate in multicounty EMS agencies. Most of the counties with response time standards measure from dispatch to arrival at the scene and most use a fractile measurement to determine compliance. Many of the ambulance enforcement programs in California have enforcement mechanisms that are unlikely to promote compliance.

Response time regulations are intended to improve the effectiveness of prehospital care. Few counties use standards that comply with recommended state standards. A large number of counties are unable to determine how well ambulance services actually comply with the standards and are not in a position to enforce them. The use of these regulatory programs is questionable based on their application.