Abstract

Understanding the epidemiological distributions of ambulance transport for patients with mild conditions according to age, disease, and geographic region could help in achieving optimal use of ambulance services. In the present study, we explored the descriptive epidemiology of ambulance transports in Hokkaido, the northernmost prefecture of Japan, identifying potential factors that determine the frequency of transports for mild diseases. Of the total 153,667 ambulance transports in Hokkaido during 2016, we found that two-thirds were for older people, of which about 60% resulted in hospital admission. There were 74,485 transports for mild cases, which were most commonly for psychiatric disorders among working-age adults (n = 4805), heart diseases among older people (n = 4246), and sensory organ diseases among older people (n = 3589). Examining the ecological correlations over 58 geographic units of ambulance services, the total unemployment rate and distance to the nearest tertiary care hospital were, respectively, positively and negatively correlated with the standardized transport ratio for multiple mild diseases. The proportion of working-age adults was uniquely identified as a possible positive predictor in mild cases of psychiatric disorders. As the identified potential predictors could be helpful in considering countermeasures, the causal links should be examined in future studies.

Highlights

  • Ambulance dispatch for emergency care in Japan is mostly a public service organized by theFire and Disaster Management Agency (FDMA), belonging to the Ministry of Internal Affairs and Communications

  • We showed that two-thirds of ambulance transports were for older people, of which about 60% resulted in hospital admission

  • We explored the descriptive epidemiology of ambulance transports for acute diseases in Hokkaido, identifying potential factors that determine the frequency of transports for patients with mild diseases

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Summary

Introduction

Ambulance dispatch for emergency care in Japan is mostly a public service organized by theFire and Disaster Management Agency (FDMA), belonging to the Ministry of Internal Affairs and Communications. Ambulance dispatch for emergency care in Japan is mostly a public service organized by the. The service adheres the Fire Service Act, and more than 90% of ambulance calls are made by patients or persons including family members who witnessed patients in need of emergency care. Out of 18 million patients of emergency care in 2015, 5.3 million (28.9%) used the ambulance transport [1]. To improve the survival rate of emergency patients, ambulances act as one of the most important parts of the social infrastructure, ensuring the health security of individuals and communities. This is even more so in Hokkaido, the largest and northernmost prefecture, covering 22% of the land area of Japan. An ambulance can reach the patient’s location in 8.6 minutes, on average, which is 1.6 minutes

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