The impact of an emergency telephone consultation service on the use of ambulances in Tokyo

• Published in: Emergency medicine journal : EMJ Vol. 28; no. 1; pp. 64 - 70
• Main Authors: Morimura, Naoto, Aruga, Tohru, Sakamoto, Tetsuya, Aoki, Noriaki, Ohta, Sachiko, Ishihara, Toru, Kushimoto, Shigeki, Ohta, Shoichi, Ishikawa, Hideki
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine 01.01.2011; BMJ Publishing Group LTD
• Subjects: Ambulances - utilization; Decision Support Techniques; Despatch; emergency ambulance systems; Emergency medical care; Emergency Medical Service Communication Systems - utilization; Emergency Medical Services - methods; Emergency Medical Services - statistics & numerical data; Expenditures; Female; Geographic information systems; Hospitalization; Humans; Male; Paramedics; Pediatrics; Perceptions; prehospital care; Remote Consultation; Risk Assessment; Safety; Telephone; telephone consultation; Time Factors; Tokyo; triage; Welfare; Tokyo; United Kingdom > UK; Japan
• ISSN: 1472-0205; 1472-0213
• DOI: 10.1136/emj.2009.073494

IntroductionThe increasing demands made on emergency ambulance services contribute to inefficient, clinically inappropriate health care, and may delay the provision of emergency care to life-threatening cases. The hypothesis of this study was that the activity for the first year of operation of an emergency telephone consultation service contributed to a reduction in ambulance use in non-urgent cases and a decrease in the cost associated with despatching ambulances.MethodsThe numbers of ambulance use and the emergency hospitalisation of ambulance cases were compared before and after the introduction of the Tokyo Emergency Telephone Consultation Centre (the #7119 centre). Public awareness of the #7119 centre in each region of Tokyo and the cost related to despatching ambulances were also investigated.ResultsA total of 26 138 consultations was performed in the initial year. Compared with the previous year, the number of ambulance uses per 1 million people decreased (before 46 846, after 44689, p<0.0001). The emergency hospitalisation rate (EHR) of ambulance cases increased significantly because of the decreased proportion of non-urgent cases (before 36.5%, after 37.8%, p<0.0001). There was a statistical correlation between the awareness rate in each region and the change of after-hours EHR in adults (R=0.333, p=0.025). The total cost related to despatching ambulances was reduced by approximately ¥678 000 000 (£4 520 000) in the initial year.ConclusionTo date, the emergency telephone consultation service has contributed to the appropriate use of ambulances and a reduction of its cost in Tokyo.