title: Comparison of rural and urban ambulance crashes in Pennsylvania.
abstract: OBJECTIVE
  To describe and compare the characteristics of, and associated injuries caused by, ambulance crashes that occur in rural versus urban areas.
  
  
  METHODS
  Crash data collected by the Pennsylvania Department of Transportation were obtained for ambulance crashes from 1997 to 2001. Crash demographics (e.g., location of crash, road conditions, and intersection type) and injuries reported by police were analyzed to determine differences, if any, between crashes occurring in rural and urban areas.
  
  
  RESULTS
  311 rural and 1,434 urban ambulance crashes were identified. Day and time of crash, light conditions, and road type were similar. Rural crashes were more likely to occur on snowy roads (13% vs. 5%) and at nighttime without street lighting (25% vs. 4%). Operator error was the most common cause of crashes (75% for rural; 93% for urban), whereas vehicle or environmental conditions more frequently affected rural drivers (25% vs. 7%). Urban crashes were more likely to involve angled collisions with other vehicles (54% vs. 19%), intersections (67% vs. 26%), and occur at a stop sign or signal (53% vs, 14%). Rural crashes often involved striking a fixed object (33% vs. 7%). Urban crashes more often involved more than one vehicle (88% vs. 56%) and more than four people total (35% vs. 23%). Pedestrian involvement was rare in both groups (< 5%). Injury severity was similar between both types of crashes, although rural crashes more frequently did not involve any injuries (33% vs. 20%). Alcohol and/or drug use by drivers was rare (< 1%).
  
  
  CONCLUSIONS
  Rural ambulance crashes usually do not involve other vehicles and are more often due to environmental or vehicle factors. Urban ambulance crashes typically involve intersections, other vehicles, and traffic signals. Although more people and vehicles are often involved in urban ambulance crashes, the severity of injuries sustained are similar.
authors: Department of Emergency Medicine, Geisinger Medical Center, Danville, PA 15215, USA. rayam2@upmc.edu
authors: Adam M
authors: AM
authors: Ray
authors: Douglas F
authors: DF
authors: Kupas
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000552:Ambulances; D006801:Humans; D010414:Pennsylvania; D012424:Rural Population; D014505:Urban Population