Name: 美國如何製造救護車危機 (How the US created an ambulance crisis)
Uploaded: 2025-06-06T02:56:57.000Z
Duration: 6 min 52 s

程度副詞

If you called for an ambulance, how long is too long to wait?

如果您呼叫救護車，等待多長時間才算過長？

Maybe you're having a heart attack, or you were in a car accident, or some other serious condition. 18 minutes?

也許你心臟病發作了，或者出了車禍，或者其他什麼嚴重的情況。18分鐘？

The gold standard is eight minute response time.

黃金標準是 8 分鐘的響應時間。

So from the time you call 911, the ambulance shows up.

是以，從你撥打 911 開始，救護車就會出現。

But if you live in any of the red areas on this map, you might be waiting longer.

但如果您住在地圖上的紅色區域，您可能需要等待更長的時間。

Areas that were outside of a 25 minute drive time.

That's Yvonne Young, one of the authors of this paper, which sought to map the position of every ambulance station in the entire US.

她就是本文作者之一伊馮娜-楊，本文試圖繪製全美每個救護站的位置圖。

They found that roughly 4.5 million people live in ambulance deserts. 4.5 million people who, if they had a stroke or were suffering cardiac arrest, might not make it to a hospital in time to survive.

他們發現，大約有 450 萬人生活在救護車荒漠中。450 萬人如果中風或心臟驟停，可能無法及時送往醫院搶救。

It makes sense that in a more spread out area, an ambulance will take longer to get to you.

在較為分散的地區，救護車需要更長的時間才能到達你的身邊，這是有道理的。

But there's more to the story than just geography.

但故事的內涵遠不止地理這麼簡單。

The rural ambulance crisis is a product of our own design.

農村救護車危機是我們自己設計的產物。

So in addition to Yvonne, I talked to some of the people overseeing that frontline response to ask, how can we fix it?

是以，除了伊馮娜之外，我還與一些負責前線響應的人員進行了交談，詢問他們：我們該如何解決這個問題？

Just popping in to say this is the first of three videos that we're doing on how emergency help gets to remote locations.

我只是想說，這是我們正在製作的三個視頻中的第一個，介紹如何將緊急救援物資送往偏遠地區。

Rural areas often struggle to get the same level of service as more populated regions.

農村地區往往難以獲得與人口較多地區同等水準的服務。

We wanted to explore what those challenges look like and what can be done to make things better.

我們希望探討這些挑戰是什麼樣子的，以及如何才能讓事情變得更好。

And we're grateful to T-Mobile, our sponsor, for supporting this video.

我們非常感謝贊助商 T-Mobile 對本視頻的支持。

T-Mobile has invested billions in getting 5G coverage across the US.

T-Mobile 已投資數十億美元在全美實現 5G 覆蓋。

And they're committed to supporting first responders and their families with exclusive savings.

此外，他們還致力於為急救人員及其家屬提供獨家優惠。

So if you want to learn more about that, check out the link below.

如果您想了解更多相關資訊，請查看下面的鏈接。

T-Mobile didn't dictate the content of this video, but their support did help make our reporting possible.

T-Mobile 沒有決定本視頻的內容，但他們的支持使我們的報道成為可能。

If your house is on fire or you are scared for your safety, you might call 911.

如果您的房子著火了，或者您擔心自己的安全，您可能會撥打 911。

And for the most part, you'd get a response that wouldn't cost you any money out of pocket.

而且在大多數情況下，你得到的答覆不會讓你掏一分錢。

Most places, the fire department and the police department are considered essential services.

在大多數地方，消防隊和警察局都被視為基本服務部門。

The government has to provide those for its population and it funds those largely through taxes.

政府必須為民眾提供這些服務，而資金主要來自稅收。

EMS in the majority is not considered an essential service.

大多數情況下，緊急醫療服務不被視為基本服務。

So your town has no obligation to provide an ambulance service.

是以，貴鎮沒有義務提供救護車服務。

Without the same government funding, payment must come in another form.

沒有同樣的政府資助，就必須以另一種形式支付。

And that's reimbursement by insurers or payment from individual patients.

這就是保險公司的報帳或患者個人的付款。

EMS is really reimbursed like they're a taxi service.

EMS 的報帳方式就像計程車服務一樣。

We only get reimbursed if we do the transport.

只有由我們負責運輸，才能報帳費用。

That is transported from the scene and taken to a hospital because that's where insurance and personal information can be established through paperwork.

從現場運送到醫院，因為那裡可以通過文書工作確定保險和個人信息。

If an ambulance responds to a call and that person doesn't want to get taken to the hospital.

如果救護車接到電話，而那個人不想被送往醫院。

There's personnel on that ambulance being paid.

那輛救護車上的人員是有工資的。

There's a service that's being provided, but there's no reimbursement for it.

雖然提供了服務，但卻沒有補償。

And this is the tricky thing about ambulance services.

這就是救護車服務的棘手之處。

All of the costs of running it, like gas, medicine, personnel, all that has to be paid for and ready to go at all times in case a call comes in.

運行的所有費用，如汽油、藥品、人員等，都必須支付，並隨時準備就緒，以備不時之需。

But regardless if one call comes in or a hundred calls come in, those costs don't change, which means the best case scenario for keeping the services funded is for them to make as many trips as possible.

但是，無論接到一個電話還是一百個電話，這些費用都不會改變，這意味著要想維持服務經費，最好的辦法就是讓他們儘可能多地出車。

Otherwise they're just sitting there burning money.

否則，他們就只能坐在那裡燒錢。

Here in the city, we could be to a call in under five minutes, spend five, 10 minutes on scene, be at the hospital in five minutes and back in service in 25 minutes.

在這座城市，我們可以在 5 分鐘內接到報警，花 5 到 10 分鐘到達現場，5 分鐘內趕到醫院，25 分鐘內恢復服務。

In some of the other counties that we're servicing, it could be a 35 minute ride just to the hospital.

在我們服務的其他一些縣，到醫院可能需要 35 分鐘的車程。

That's an hour, hour plus that your unit's out of its area.

你的小分隊離開自己的區域要一個多小時。

Cities also generally have more calls because they have more people and more incidents.

城市一般也會有更多的電話，因為它們有更多的人和更多的事件。

In sparsely populated, remote, rural locations, they're only doing 30 runs a year.

在人煙稀少、偏遠的農村地區，他們一年只能跑 30 次。

是以，要實現收支平衡相當困難。

That low volume of calls also makes it hard to pay emergency workers who work around the clock, which is related to another thing commonly true of rural emergency response.

出警量少也很難支付全天候工作的應急人員的工資，這與農村應急工作的另一個普遍現象有關。

I mean, if people can't make a living off of it, then we're reduced to volunteers.

我的意思是，如果人們不能以此為生，那我們就只能當志願者了。

Volunteers are an essential part of EMS response in rural areas.

志願者是農村地區急救服務的重要組成部分。

The overhead costs of running an ambulance are high.

So rural communities often rely on unpaid non-professionals to save on those personnel funds.

是以，農村社區往往依靠無報酬的非專業人員來節省這些人員經費。

We have set up this system where your CPA, your plumber, might also be your EMT when you call 911.

我們建立了這樣一個系統，當你撥打 911 時，你的註冊會計師、水管工可能同時也是你的急救醫生。

It's just hard to recruit people working two and three jobs.

只是很難招募到打兩份或三份工的人。

And a lot of the members that are still holding down the fort and responding to a lot of the calls are members that have been there from the beginning.

而現在仍在堅守崗位、回覆大量電話的很多成員都是從一開始就在那裡的。

All that, the lower volume, less reimbursement, and shrinking volunteer pool, that's what adds up to slower response times.

所有這一切，再加上數量減少、報帳額度降低、志願者隊伍縮減等因素，導致響應時間變慢。

There are areas of the state where you do not want to, you know, have an accident because there's no one, no one will be coming, at least not in a timely manner.

在該州的一些地區，你不會希望發生事故，因為那裡沒有人，至少不會有人及時趕來。

The sticky situation we find ourselves in with EMS is ultimately about resources and the issues of distributing them.

我們發現自己在緊急醫療服務方面陷入的困境歸根結底是資源和資源分配問題。

The study that we did in North Dakota, we not only looked at ambulance deserts, but we looked at if we could place them wherever we wanted, what would be the optimal set of locations?

我們在北達科他州所做的研究不僅考察了救護車沙漠，還考察瞭如果我們可以將其放置在任何我們想要的地方，那麼最佳地點會是哪裡？

And we were able to show you could serve the whole state with fewer number of ambulances and cover the whole state.

我們能夠證明，用較少的救護車就能為全州提供服務，並覆蓋全州。

The problem really is is that these ambulances are organized by community goodwill.

真正的問題在於，這些救護車是由社區的善意組織起來的。

You can't tell these communities, oh, sorry, you've got it in the wrong spot.

你不能告訴這些社區，哦，對不起，你找錯地方了。

Part of the solution might be that we need to start thinking about EMS designation as an essential service.

部分解決方案可能是，我們需要開始考慮將緊急醫療服務指定為一項基本服務。

Some places have started ambulance tax districts where local taxes do pay for EMS.

有些地方已經設立了救護車稅區，由地方稅收支付急救服務費用。

The community I live in just started an ambulance tax district.

我居住的社區剛剛開始徵收救護車稅。

They're paying to make sure that there's 24-7 coverage.

他們付錢是為了確保全天候服務。

對我來說，一年的費用約為 180 美元。

Robert Steems has started operating in some ambulance tax districts.

Robert Steems 已開始在一些救護車稅區開展業務。

Significant reduction in response times and significant reduction in mutual aid where they have to rely on other communities to back them up.

大大縮短了響應時間，並大大減少了需要依靠其他社區支援的互助次數。

Ultimately though, experts think the problem will require large-scale change.

不過，專家們認為這個問題最終需要大規模的變革。

We need to get the reimbursement rates up so that we're actually getting paid for the level of service that we're providing.

我們需要提高報帳比例，這樣我們才能真正獲得與我們所提供的服務水平相稱的報酬。

Until they change the reimbursement of those services, we will continue to be in crisis.

除非他們改變這些服務的報帳方式，否則我們將繼續面臨危機。

If you're ever in that situation where you need to dial 911, you don't want to have to worry about the system being in crisis.

如果您遇到需要撥打 911 的情況，您不必擔心繫統會出現危機。

The service that's being provided is just as critical and crucial as police and fire.

所提供的服務與警察和消防一樣重要和關鍵。

So it's time to be recognized for that and give us avenues of recruiting and training and funding that's going to allow us to address that EMS crisis.

是以，是時候承認這一點，併為我們提供招聘、培訓和資金管道，讓我們能夠應對急救服務危機。