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The impact of an emergency telephone consultation service on the use of ambulances in Tokyo
  1. Naoto Morimura1,
  2. Tohru Aruga2,
  3. Tetsuya Sakamoto1,
  4. Noriaki Aoki3,
  5. Sachiko Ohta3,
  6. Toru Ishihara4,
  7. Shigeki Kushimoto5,
  8. Shoichi Ohta6,
  9. Hideki Ishikawa7,
  10. the Steering Council of Tokyo Emergency Telephone Consultation Centre
  1. 1Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
  2. 2Department of Critical and Emergency Medicine, Showa University hospital, Tokyo, Japan
  3. 3Center for Health Service, Outcome Research and Development–Japan, Tokyo, Japan
  4. 4Shirahigebash Hospital, Tokyo, Japan
  5. 5Nippon Medical School, Department of Critical Care Medicine, Bunkyo-ku, Tokyo, Japan
  6. 6Tokyo Medical University, Department of Emergency Medicine, Tokyo, Japan
  7. 7Eijyu General Hospital, Tokyo, Japan
  1. Correspondence to Dr Naoto Morimura, Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga Itabashi-ku, Tokyo 173-8606, Japan; molimula{at}r6.dion.ne.jp

Abstract

Introduction The 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.

Methods The 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.

Results A 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.

Conclusion To date, the emergency telephone consultation service has contributed to the appropriate use of ambulances and a reduction of its cost in Tokyo.

  • Despatch
  • emergency ambulance systems
  • prehospital care
  • telephone consultation
  • triage

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Footnotes

  • Members and investigators who participated in the Steering Council of Tokyo Emergency Telephone Consultation Centre are listed in the appendix.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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