Can dedicated ambulances improve the efficiency of the neonatal emergency transport service?

To assess whether dedicated ambulances would improve the efficiency of the neonatal emergency transport service (NETS).

The efficiency of NETS was investigated in the Lazio region, Italy, by comparing data collected during the first 6 months of 1997 (from 1 January to 30 June), with those collected during the same months of 2000, using NETS availability and time investment as indicators. The data yielded by the study were reported as number and percentage, and were analyzed by SPSS 10.1 software; chi2 analysis with Pearson's correction was used to assess the statistical significance of the differences between the two groups; p < 0.05 was considered statistically significant.

Our investigation showed a reduced availability of the service in 2000, compared to 1997 (90.4% vs. 95%; p < 0.03). We also noted that in 2000 all dedicated ambulances remained off duty for 26 days, owing to engine failure. The response time and the total transfer time where much longer in 2000 than in 1997 (response time > 30 min in 8% vs. 3%, p < 0.008; total transfer time > 120 min in 37% vs. 30%, p < 0.04).

The reduced efficiency in 2000 was mainly due to the lack of ambulances used to replace the dedicated ambulances. However, the type of ambulance that may provide the best replacement for NETS remains an unsolved question.