Japan: Japan’s EMS is run by local fire departments. Each city or town has its own fire department that answers 119 calls and sends out ambulances. The national Fire and Disaster operate the same way across the country. Hungary uses a single, nationwide service called the from the top down—training, equipment, vehicles, even Japan: Since there are no doctors riding in most ambulances, Japanese paramedics rely on online medical control. A take and which hospital is best equipped for the patient’s condition. This system works smoothly but can add a little extra time for each decision. Both systems excel in different respects. Japan’s fire-standardization, and robust dispatch oversight but limits pre- Hungary’s integrated NAS provides broader paramedic autonomy and physician presence on scene, fostering rapid When prioritizing timeliness and resource efficiency, Japan’s Organizational StructureManagement Agency sets broad rules, but each local department handles its own staffing, training, and equipment. This “one-tier” system means most ambulances look and Hungary:National Ambulance Service (NAS). It is managed by the national government and divided into seven regions, each with many local stations. Because everything is organized uniforms—patients receive the same standard of care no matter where they are in Hungary.doctor at the dispatch center advises them on what steps to department model ensures uniform coverage, cost-effective hospital interventions through mandatory physician control. ALS delivery, yet demands greater resources and staffing.Dispatch System and Call TriageJapan: When someone dials 119, the call goes to a local fire department center. Call-takers use a set list of questions to decide how serious the situation is and what kind of help is needed. In many areas, doctors sit in these centers to guide paramedics by phone, helping pick the right hospital and treatment plan before the ambulance even arrives.Hungary: Hungarians dial 104 (or the European emergency number 112), and callers reach one of 19 regional dispatch centers. These centers are staffed by trained paramedics or doctors who quickly sort calls based on severity. They send the nearest ambulance team and give them any extra medical advice needed over the radio. A central hub in Budapest coordinates resources across the country, making sure no area is left without backup during big emergencies.Hungary: Hungarian ambulance teams often include a doctor, especially for the most serious cases. Having a doctor right on the scene lets the team decide on the spot which hospital specialty—cardiac, stroke, trauma—is most appropriate. They can also arrange helicopter transport or a mobile intensive care unit if needed, reducing delays caused by transferring patients between facilities.model is advantageous. However, for maximizing on-scene care quality and autonomous advanced interventions, Hungary’s Franco-German approach is superior. Given the critical importance of early ALS in improving survival, the Hungarian system—despite its higher costs—offers greater potential to save lives in severe emergencies.2. How the EMS Systems Are Organized Coordination with Medical Institutions Conclusion7
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