The pre-hospital pulse: high responsiveness, deployment, and utilisation of ambulance services in India.

BACKGROUND

India's National Ambulance Service, a key component of the public health system, operates through 102, 108, and 112 hotline networks.

OBJECTIVE

To assess ambulance performance in terms of responsiveness, deployment, and utilisation. A descriptive study was conducted using ambulance records from two large states in India, Punjab and Haryana, from January to December 2025.

RESULTS

Of 626,372 hotline calls (72% from rural areas), 97% resulted in ambulance deployment, and 92% were utilised for patient transfers. 91% of ambulances reached the pickup location within 30 min (response time) and 67% transported patients to health facilities within 60 min (call-to-drop time). Median distance travelled by ambulance (parking to drop location) was 32 km (interquartile range 17-58). In Punjab, 50% of call-to-drop times were within 60 min, while in Haryana this was 74%. There were notable interdistrict variations in call-to-drop times. The most common reasons for hotline calls were maternal and obstetric conditions (37%), medical emergencies (27%), and trauma or accidents (17%). Inter-facility transfers accounted for 61% of ambulance utilisation.

CONCLUSION

Our study demonstrates that ambulance services perform at a high level and provide substantial public health value. However, opportunities remain to further strengthen performance, particularly in reducing call-to-drop times.