ObjectiveTo examine the contribution of the active job openings-to-applicants ratio, a macroeconomic indicator, to the number of ambulance dispatches.DesignLongitudinal ecological study.SettingJapan, between January 2003 and December 2021.ParticipantsAll ambulance dispatches.Primary and secondary outcome measuresThe contribution of the active job openings-to-applicants ratio in a month, adjusted by the number of older people, mean temperature and total population, to the number of ambulance dispatches in that specific month was examined and the primary model was compared to the conventional model considering only the older population, mean temperature, and total population.ResultsThere were 108 724 969 ambulance dispatches during this period. The active job openings-to-applicants ratio was significantly associated with the number of ambulance dispatches (the increase rate of monthly ambulance dispatches for 1% rise in the active job openings-to-applicants ratio, 1.00082; 95% CI 1.00052 to 1.00112). Additionally, the primary model effectively demonstrated better fitness to the actual trend than the conventional model (the quasi-likelihood under the independence model criteria were −2 626 817 720 and −2 626 775 185, respectively).ConclusionsThe number of ambulance dispatches was correlated with the active job openings-to-applicants ratio. Macroeconomic perspectives may be needed to address the issue of increasing ambulance dispatches.