The pre-hospital emergency services (PES) play a vital role in improving the survival and recovery rates of the injured after an earthquake, which, however, may also be interrupted during the earthquake. Appropriate quantitative approaches for assessing pre-hospital seismic resilience (PSR) are lacking, making it challenging to take resilience enhancement measures. This study proposes a new assessment approach for PSR based on agent-based modeling. The pre-hospital functionality is mathematically defined and simulated, of which the functionality curve is then applied to assess its PSR. The proposed approach is validated through a case study in China. This study advances the existing research to understand the influencing factors and the evolution of PSR and allows quantitative assessment of PSR. The outcomes will also contribute to developing effective resilience enhancement measures for decision-makers.
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