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In the United States, private (for-profit) companies have been playing a greater role in the provision of paramedic services and medical transportation, although with increasing competition from city fire departments. Today they account for around 40 percent of these services in major cities. In Denmark, around 85 percent of ambulance services are provided by a private company, and in other European countries, private not-for-profit organisations dominate.
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| 2006 JEMS 200-City Survey: EMS From All Angles (PDF) |
| Williams, David M., 2007 |
| Journal of Emergency Medical Services, Elsevier Inc. |
| Yearly survey of the largest emergency medical services systems across the United States of America, and provides a ‘snapshot of the industry’ and can be used for benchmarking purposes. |
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| USA |
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| 2005 JEMS 200-City Survey (PDF) |
| Williams, David M., 2006 |
| Journal of Emergency Medical Services, Vol. 31, No. 2 |
| The 2005 survey of first responder and transport units that serve emergency medical services in 200 cities throughout the USA. The survey reveals that private organisations and fire departments are the most common ambulance types, and that the decision between public and private funding reflects the effect of the trade-off between subsidy and price. |
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| USA |
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| 2004 JEMS 200-City Survey (PDF) |
| Williams, David M., 2005 |
| Journal of Emergency Medical Services, Vol. 30, No. 2 |
| A yearly updated survey of first responders and transport services of emergency medical services in the most populous US cities. For the first time in recent years, fire based emergency medical services provided the majority of primary emergency transport, but this may be a methodological effect due to the nature of the respondents. |
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| USA |
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| 2003 JEMS 200-City Survey (PDF) |
| Monosky, Keith A., 2004 |
| Journal of Emergency Medical Services, Vol. 29, No. 2 |
| Comparative analysis of the emergency medical services in the 200 most populous cities in the USA, relating to both first response and transport shows that the fire department continues to be the dominant agency type in the delivery of first response. |
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| USA |
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| 2002 JEMS 200-City Survey (PDF) |
| Monosky, Keith A., 2003 |
| Journal of Emergency Medical Services, Vol. 28, No. 2 |
| Annual report on the operational and clinical trends in emergency medical services of two hundred cities in the USA for the year 2002. Increased standardisation can be seen across the nation, but functional differences remain across the country. |
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| USA |
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| Emergency Medical Services Privatization: Frequently Asked Questions (PDF) |
| Balaker, Ted and Summers, Adam B. , 2003 |
| Reason Public Policy Institute, Reason Foundation, Policy Study No. 310 |
| Defining privatisation in a broad way to encompass public-private partnerships, the authors address issues and questions regarding the introduction of the private sector into the provision of emergency medical services. In particular, the questions concern the role of private providers, the nature of contracting, accountability, and what the private sector can offer to improve services. |
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| USA |
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| 2001 JEMS 200-City Survey (PDF) |
| Cady, Geoff, 2002 |
| Journal of Emergency Medical Services, Vol. 27, No. 2 |
| The 2001 nationwide survey of emergency medical service responders and transport services across cities in the USA is designed to assess the flexibility and preparedness of emergency service providers to respond to changing requirements, in particular the implementation of the Medicare fee schedule. |
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| USA |
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| Where Do 911 System Ambulances Take Their Patients? Differences Between Voluntary Hospital Ambulances and Fire Department Ambulances (Web Page) |
| Hevesi, Alan G. , 2001 |
| City of New York Office of the Comptroller, Office of Policy Management |
| The study looks at whether patients are transported to the nearest appropriate hospital. It finds that voluntary hospital ambulances ‘steer’ patients towards their sponsor hospitals. This may affect patients’ health when the trip takes longer than necessary, or the hospital they are transported to is inappropriate to their condition. This, also, has a negative impact on the financing of public hospitals. The report finishes with key recommendations to ensure ambulances take patients to nearest appropriate hospital, in particular monitoring of voluntary hospital ambulances. |
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| USA |
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| Test Calls Made to Non-Emergency Ambulance Telephone Lines (PDF) |
| Auditor General of Victoria, 1999 |
| Government Printer for the State of Victoria, No. 18 - Session 1999-2000 |
| Audit report to assess the action taken by government agencies in response to allegations of a private sector emergency line contractor misrepresenting their call statistics and, therefore, intentionally defrauding the public. The report identifies the need for enhanced communication between all parties, especially with outsourcing arrangements and large contracts. The report also calls for a widening of the powers of the Auditor-General to access information and documents held within the private sector. |
| ISBN 0731155068 |
| Australia |
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| Metropolitan Ambulance Service: Contractual and Outsourcing Practices (PDF) |
| Auditor General of Victoria, 1997 |
| Government Printer for the State of Victoria, Special Report 49, 1996-97 |
| An audit report of the provision of ambulance services in Victoria. The audit identified significant flaws in contract management in tendering, contracting and outsourcing. Expected savings are unlikely to be achieved and there are further questions concerning the integrity of the former management, regarding documentation and dubious practice. The audit looks specifically at the implementation of a computerised communications system, and other specific outsourcing and consulting arrangements. |
| ISBN 0730692906 |
| Australia |
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| Metropolitan Ambulance Service: Fulfilling a Vital Community Need (PDF) |
| Auditor General of Victoria, 1997 |
| Government Printer for the State of Victoria, Special Report 50, 1996-97 |
| Report of an audit of the Metropolitan Ambulance Service of Victoria, concentrating specifically on: emergency call-taking and dispatch system, the effectiveness of the service’s emergency response, standard of clinical care, non-emergency patient transport services and financial and strategic management. It finds the performance of ambulance teams has improved. Current management is competent but limited by defective contracts that were previously entered into, especially in terms of improved efficiency and expected savings being realised. |
| ISBN 0730692922 |
| Australia |
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| Privatizing Emergency Medical Service: How Cities Can Cut Costs and Save Lives (PDF) |
| Poole, Robert W. Jr., 1995 |
| Reason Foundation |
| This guide argues that it is not the type or identity of the provider of emergency medical services (EMS), but the design of the system that is a key factor in EMS performance and costs. The guide offers guidelines on how to implement appropriate contractual arrangements to achieve costs savings and improve performance, and the role state governments should play. |
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| USA |
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| A Century of Service to Mankind: A History of the St John Ambulance Brigade |
| Cole-Mackintosh, Ronnie, 1996 |
| Century Bentham Ltd |
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| The Red Cross and the White |
| Saunders, Hilary St George, 1949 |
| Hollis & Carter |
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| UK |
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| The St. John Ambulance Association: Its History, and its Part in the Ambulance Movement |
| Fletcher, N. Corbet, 1929 |
| The St. John Ambulance Association |
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