The Effect of Ambulantory Emergency Service Accessibility on Health Care Outcomes

This study examines the impact of ambulatory emergency service (AES) accessibility on health care outcomes in Slovakia. Exploiting exogenous variation from the 2016 and especially the 2018 policy reforms that substantially expanded AES availability across districts, the authors employ a two-way fixed e!ects model and an event study design to identify e!ects on hospitalizations and ambulance dispatches. The analysis is based on individual-level data covering the period 2014–2022. The findings indicate that greater AES availability reduces general hospitalizations and lowers ambulance dispatches, suggesting a substitution e!ect between AES and ambulance services. Overall, the study provides empirical evidence that decentralized emergency services can enhance health system efficiency by reducing reliance on more costly hospital care and ambulance interventions.