A discussion of the organization of emergency ambulance agencies and their communications systems, levels of training of personnel, and travel time characteristics. The report is based on data obtained from 179 grant applications to the Robert Wood Johnson Foundation, representing agencies that serve about two-thirds of the population of the United States. Findings include: (1) Purveyors for whom emergency service is a secondary function are gradually being phased out. (2) Nationwide standards concerning citizen access to emergency medical help, training of personnel, and communication systems, which have been developed without evaluative studies showing they are valid, are not now met by most agencies. (3) Obstacles to rapid installation of dial 911 systems are still severe, with many regions opting temporarily for alternative access systems, such as use of area code 800. However, ambulance agencies believe they can correct existing command-and-control deficiencies within a two-year period, given sufficient funding. 49 pp. Ref.
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