Background Timely advanced hospital level care gives the injured patient the best chance of survival from time critical injury. Little is known about the coverage and accessibility of emergency ambulance services in New Zealand despite the fact that New Zealand’s long travel distances and dispersed population present many challenges to the delivery of timely access to emergency services and healthcare.

Aims To determine the geographical and population coverage of emergency ambulance services and advanced hospital level care providers in New Zealand. Methods: The emergency ambulance service (road and air) response time from each meshblock (smallest geographical area used by Statistics NZ) was estimated using the location of: 1) the nearest emergency ambulance stations and 2) the nearest advanced hospital service. Physical addresses of ambulance stations and advanced hospital services were converted to geographic coordinates and estimates of driving and flying response times (sum of despatch time, travel time from ambulance base location, on-scene time and hospital travel time) for each meshblock were calculated. Meshblocks covered by existing emergency ambulance services within the ‘golden-hour’ were identified.

Results The majority (84%) of the NZ population have emergency ambulance access to advanced level hospital services within 60 min. Sub-populations with poor emergency coverage include older residents, Indigenous Maori and those living in regions with low to moderate population density.

Discussion and conclusions Over 6 94 000 (16%) New Zealanders do not have timely access within 60 min to advanced level hospital care with areas of disparities in access found, suggesting opportunities exist to maximise access to these services to increase the chances of survival from serious trauma in New Zealand. The findings of this research will be used to inform trauma system planning and acute hospital level trauma care in New Zealand as it develops further.