A Systematic Review Of Factors Influencing Ambulance Response Time In Saudi Arabia

Abstract

Background:
Ambulance response time (ART) is a key performance indicator in emergency medical services (EMS) and has a direct impact on patient outcomes, especially in time-sensitive emergencies. In Saudi Arabia, despite investments in EMS infrastructure, significant regional and operational disparities persist, affecting ART and the overall quality of prehospital care.

Objective:
This systematic review aims to identify, synthesize, and analyze the factors influencing ambulance response time in Saudi Arabia, providing evidence to guide policy reforms and operational improvements in line with national health transformation goals.

Methods:
Following PRISMA 2020 guidelines, a systematic search was conducted across six databases (PubMed, Scopus, Web of Science, CINAHL, Google Scholar, and Saudi Digital Library) for studies published between 2010 and 2025. Inclusion criteria encompassed empirical studies focused on ART within Saudi Arabia. A total of 26 studies were included, and data were extracted and thematically analyzed. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment.

Results:
Five major themes emerged as key influencers of ART: (1) geographical and environmental factors (e.g., traffic congestion, rural remoteness), (2) dispatch system and communication infrastructure, (3) EMS workforce capacity and gender composition, (4) organizational and policy-related barriers, and (5) sociocultural influences on EMS utilization. Regional disparities and systemic inefficiencies were consistently reported, with limited implementation of standardized ART benchmarks.

Conclusion:
Ambulance response time in Saudi Arabia is shaped by a complex interplay of operational, infrastructural, and socio-cultural factors. National strategies should focus on optimizing fleet distribution, strengthening dispatch systems, expanding the EMS workforce (including female paramedics), and improving public awareness. Establishing national ART benchmarks and enhancing inter-agency coordination are critical steps to ensure equitable and timely emergency care.