Tertiary emergency care in Japan

Abstract

Medical science is no exception to trends in subdivision and specialization. In light of this, emergency care is gaining wide recognition as a specialized area of clinical medicine. In general, emergency care is administered by an independent emergency department of a general hospital. Traditionally, the emphasis in the management of emergency patients in Japan had been on primary care and first aid. Based on this tradition and the structure of medical practice peculiar to Japan, an emergency system of “critical emergency transfer” has been established (Fig. 1). In this system, emergency receiving facilities are divided into three categories: primary, secondary, and tertiary. Emergency patients first visit a primary facility and. when necessary, are transported to secondary or tertiary centers. This system has provided the Japanese public with efficient, high-quality medical care. It has also given rise to a new area of clinical science called “pantraumatology. ’ ’ Osaka is one of the areas in Japan where the emergency care system was organized earliest, and Osaka University Hospital played the leading role. Fifteen years have elapsed since the tertiary emergency center was established at Osaka University Hospital. Since then a number of tertiary centers have sprung up in various parts of the prefecture. We reviewed the records of 1 I tertiary emergency centers in Osaka to assess this sytem of stratified emergency care and transfer.