Ambulance Emergency Response Optimization (AERO)

  • Researcher Justin with a toy ambulance

Time sensitive medical emergencies, including many maternal and child health issues, are responsible for one third of deaths in low and middle-income countries. Many of these deaths can be avoided with faster ambulance response. Dhaka, the capital city of Bangladesh and the tenth largest city in the world, does not currently have a centralized emergency medical service (EMS) system and primarily relies on private ambulance services to transport patients. The lack of a coordinated EMS system has resulted in poor ambulance positioning, inefficient response routes, and subsequently, restricted access to health care. The ambulance emergency response optimization (AERO) project aims to build a coordinated EMS effort and reduce ambulance response times in developing urban centres by determining the optimal locations to station ambulances and the best routes to reach each patient.

Dhaka presents a unique challenge because the road network, like in many developing urban centers, is very unpredictable. Traffic can be extremely congested, yielding to ambulances is not the norm as it is here in Canada, and violence/political demonstrations often cause route disruptions. To address these challenges, we developed a robust ambulance location and network flow model that accounts for traffic uncertainty. We used GPS technology to collect and estimate travel time information across the city for different times of day and days of the week. To estimate future ambulance demand, we obtained the 2011 census and used surveys to collect information from 3000 patients arriving to emergency rooms in 17 major hospitals across Dhaka.

Quick Facts

  • Dhaka is the 10th largest city in the world but does not have an EMS system or 9-1-1 type number
  • Dhaka has a population density of over 20 000 people per square km, five times that of Toronto
  • Dhaka has over 600 000 rickshaws, the most in the world
  • The most popular mode of transportation in emergency situations was a rickshaw (40% of patients)
  • Only 5% of patients used an ambulance in emergency situations
  • Average time to reach a hospital was 41 minutes
  • 93% of surveyed patients had a cell phone

Videos


Team Members

Timothy C.Y. Chan

Principal Investigator

Moinul Hossain

Data collection and traffic modelling

Publications

  • Boutilier, J.J., Hossain, M., Chan, T.C.Y. (2015). “Ambulance Emergency Response Optimization in Dhaka, Bangladesh,” Working Paper.
  • Boutilier, J.J., Hossain, M., Chan, T.C.Y. (Nov 2015). “Ambulance Emergency Response Optimization in Dhaka, Bangladesh,” 2015 INFORMS Annual Meeting, Philadelphia, PA.
  • Boutilier, J.J., Hossain, M., Chan, T.C.Y. (June 2015). “Ambulance Emergency Response Optimization in Dhaka, Bangladesh,” 2015 CORS/INFORMS International Conference, Montreal, QC.
  • Boutilier, J.J., Hossain, M., and Chan, T.C.Y. (Nov 2014). “Ambulance Emergency Response Optimization,” Global Health Innovation Summit 2014, Toronto, ON.
  • Boutilier, J.J., Hossain, M., and Chan, T.C.Y. (Apr 2014). “Ambulance Location and Routing under uncertainty in Dhaka, Bangladesh,” Resuscitation in Motion 2014, Toronto, ON.