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Impact of motorcycle ambulances on prehospital response time: a systematic review
Rahim Ali Sheikhi1, Mohammad Heidari2, Bahar Seifi3
1Department of Disasters and Emergencies, Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Background:
Urban traffic congestion and limited ambulance fleets are associated with prolonged Emergency Medical Services (EMS) response times and worse outcomes in time-critical conditions. To reduce response times, many EMS agencies in large cities have introduced motorcycle ambulance services.
Methods:
We systematically reviewed English-language literature from January 2008 to November 2025 in PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar, following PRISMA 2020 guidelines. Two reviewers independently screened records, extracted data, and assessed risk of bias. Inclusion criteria were original peer-reviewed studies evaluating motorcycle-based EMS units with quantitative prehospital time outcomes. Given substantial heterogeneity in designs and settings, we performed a qualitative synthesis without meta-analysis.
Results:
Of 713 records identified, 7 studies met inclusion criteria. Included studies reported that motorcycle ambulances generally achieved shorter response times than standard ambulances in congested urban settings. Where numerical estimates were extractable, reported differences ranged from approximately 30 seconds to 2-3 minutes faster response with motorcycle units; one study reported an approximately 23.5% reduction in unnecessary car-ambulance dispatches. However, confidence intervals and adjusted statistical indicators were inconsistently reported. Motorcycle deployment was also associated with fewer unnecessary ambulance dispatches, particularly for low-acuity calls.
Conclusions:
Motorcycle ambulances may improve prehospital EMS response times, particularly in congested urban areas and settings with limited road infrastructure. Available studies reported favorable point estimates, but the evidence base is small, heterogeneous, and predominantly observational, with limited data on patient outcomes, safety, and cost-effectiveness. No pooled effect estimate can be justified. Further high-quality studies are needed to clarify the benefits, risks, and optimal role of motorcycle-based EMS within broader emergency care systems.
