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This study examines the statewide service coverage of emergency medical services (EMS) in view of public health planners, policy makers, and ambulance service managers. The study investigates the statewide service coverage in a mixed region of urban, rural, and frontier regions to address the importance of ambulance service coverage at a large scale. The study incorporated statewide road networks for ambulance travel time, census blocks for population, and backup service coverage using geographic information systems (GIS). The catchment areas were delineated by the travel time after subtracting chute time for each Census Block as an analysis zone. Using the catchment areas from the ambulance base to the centroid of Census Block, the population and land coverage were calculated. The service shortage and multiple coverage areas were identified by the catchment areas. The study found that both reducing chute time and increasing the speed of emergency vehicles at the same time was significantly more effective than improving only one of two factors. The study shows that the service is improved significantly in frontier and urban areas by increasing driving time and chute time. However, in rural areas, the improvement is marginal owing to wider distribution than urban areas and shorter threshold response time than frontier areas. The public health planners and EMS managers benefit from the study to identify underserved areas and redistribute limited public resources.

The total population covered by the current ambulance service under threshold response time and policy is one of the major concerns for policymakers and ambulance service designers. This study investigates the statewide service coverage based on regional types of urban, rural, and frontier to address emergency medical service (EMS) disparity. A statewide ambulance coverage case study is conducted for the state of North Dakota. This study revisited the spatial key performance indicators (SKPIs) of EMS and proposed innovative spatial modeling for statewide EMS coverage in view of service users, providers, and public health designers. Statewide ground ambulance service coverages were mapped to three types of indicators, including: (a) geographical backup coverages; (b) predicted response and travel time distance at census block level; and (c) the ratio of population being covered by the threshold response time coverage at the county level using GIS. The study demonstrated that the service shortage and multiple service areas are clearly explained using the suggested SKPIs, and the underserved areas are drilled down into expected response and travel time for each census block and the population‐covered ratio for each county for further investigation. [ABSTRACT FROM AUTHOR]