Volunteering and operational efficiency in emergency services: Evidence from the Military Fire Brigade of Santa Catarina

Abstract

We investigate whether the presence of volunteers increases the operational efficiency of prehospital care provided by the Military Fire Brigade of Santa Catarina in contexts of simultaneous calls. The analysis focuses on two central intervals of the response process: mobilization time, defined as the period between dispatch and vehicle departure, and on-scene care time, corresponding to the interval between arrival at the scene and the conclusion of assistance. We use administrative microdata from E-193, extracting medical emergency occurrences with ambulance transport recorded between January 2023 and June 2025. After applying simultaneity and plausibility filters, the samples comprise 3,046 occurrences for the mobilization stage and 3,475 for the care stage. The empirical strategy is based on the potential outcomes framework and estimates the average treatment effect on the treated through balancing methods combined with generalized linear models. The results show that the volunteerism required to enable dispatch reduces mobilization time by a small but statistically robust margin, with magnitudes ranging from approximately 12 to 57 seconds, with the most conservative estimates concentrated around 12 to 14 seconds. This effect should not be interpreted as negligible, since in time-sensitive prehospital care, even short reductions can be operationally relevant and, in certain contexts, potentially clinically important. The presence of an additional volunteer on scene reduces care time by approximately 3 to 7 minutes. Together, the findings indicate that volunteerism does not replace professional staff but complements the permanent structure by increasing the system's response capacity in situations of higher demand pressure.