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Background: An efficient ambulance service is a vital component of emergency medical services. We determined the emergency ambulance response and transport times and ambulance exit outcomes in Bhutan. Methods: A cross-sectional study involving real-time monitoring of emergency ambulance deployments managed by a central toll-free (112) hotline (20 October 2021 to 20 January 2022) was carried out. Results: Of 5092 ambulance deployments, 4291 (84%) were inter-facility transfers, and 801 (16%) were for emergencies. Of the latter, 703 (88%) were for non-pregnancy-related emergencies (i.e., medical, surgical, and accidents), while 98 (12%) were for pregnancy-related emergencies. The median ambulance response and patient transport times were 42 (IQR 3–271) and 41 (IQR 2–272) minutes, respectively. The median round-trip distance travelled by ambulances was 18 km (range 1–186 km). For ambulance exit outcomes that were pregnancy-related (n = 98), 89 (91%) reached the health facility successfully, 8 delivered prior to ambulance arrival at the scene or in the ambulance during transport, and 1 had no outcome record. For the remaining 703 non-pregnancy deployments, 29 (4.1%) deployments were deemed not required or refusals, and 656 (93.3%) reached the health facility successfully; 16 (2.3%) died before the ambulance’s arrival at the scene, and 2 (0.3%) were not recorded. Conclusions: This first countrywide real-time operational research showed acceptable ambulance exit outcomes. Improving ambulance response and transport times might reduce morbidities and mortalities further. Full article

Transit smart card records detail travel information of passengers, which provides abundant data for analyzing public travel patterns. Regular travelers’ information extracted from smart card data (SCD) have been extensively analyzed. However, rare studies have been devoted to non-roundtrips, which account for a relatively large portion of the overall transit ridership, especially in metropolises such as Beijing. This study aimed to reveal the non-roundtrip pattern using the passenger travel data obtained from SCD. Weekly non-roundtrip SCD were used to analyze the spatiotemporal distribution patterns of overall and typical non-roundtrips’ origins and destinations (ODs). Also, subway data and bus data were combined and visualized in geographic information system (GIS). The reasons for frequent non-roundtrips generated in the metropolitan city were inferred. The results demonstrate some detected spatiotemporal patterns of non-roundtrips. It is not surprising that a large proportion of non-roundtrips serve as a rail access to intercity, but there are still many trips of this kind showing a commuting pattern. Merging SCD with bus data, the results also reveal that passengers may choose other modes as a substitute return transportation option due to rail fare or overcrowding problem. This study focused on irregular trips normally neglected in the literature and found that the number of these trips is too large to be ignored in a diversified city like Beijing. Meanwhile, the travel patterns of non-roundtrips extracted can be used to direct the operation strategies for both rail and bus. The research framework raised here could be applied in other cities and comparative analysis could be done in the future. Full article