A US National Study of the Association Between Income and Ambulance Response Time in Cardiac Arrest

Our analysis demonstrated that EMS responding to low-income communities had a lower likelihood of meeting 8-minute and 15-minute national benchmarks compared with EMS responding to highincome communities and showed that the mean EMS response time, on-scene time, and transport time were longer in low-income communities, even after controlling for observable differences. Given that whether or not a patient survives cardiac arrest can depend on a matter of minutes, even small delays in EMS response times may negatively alter patient outcomes. Our findings are disturbing given that poorer neighborhoods have higher rates of disease and other structural disparities in health care access that further compound their risk for worse outcomes. Our study shows that these structural disparities begin as early as the initial EMS activation and the resulting services, which is an area previously more traditionally administered by public services and considered less vulnerable to market forces. Recent trends in the financing and delivery of prehospital care suggest that these disparities are likely to worsen unless fewer economically driven forces are introduced. Understanding where gaps exist can help guide improvements in policies and develop interventions to address prehospital care disparities and ultimately disparities in patient outcomes.

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