Strained Emergency Medical Services: Curbing Use by Patients with Minor Symptoms Essential

The growing number of people transported to hospitals after calls to the 119 emergency number has stressed the nation’s emergency medical care system. A plan should be developed to curb the use of emergency medical services by those with minor symptoms in order to ease the burden on medical personnel and paramedics. 

The number of emergency ambulance dispatches was 7.23 million in 2022, up 40% from 5.1 million in 2008. As the figure is expected to continue rising due to the aging of the population, a challenge is now how to maintain the emergency medical system toward the future.

Some countries charge for the use of ambulances, but such services have been provided free of charge in Japan. In 2016, an expert panel of the Fire and Disaster Management Agency of the Internal Affairs and Communications Ministry pointed to the need for careful discussions regarding the introduction of a system to charge for the use of ambulances.

Needless to say, it is desirable to maintain the current free system to prevent people in financial straits from being reluctant to call for emergency medical care. However, it defeats the purpose if the emergency medical system itself collapses.

The problem is that there is no end in sight to an increase in the number of people who casually call for ambulances for such reasons as “lack of transportation” to treat symptoms that do not require urgent care.

Of the 6.22 million people transported for emergency care nationwide in 2022, those with minor symptoms who did not require hospitalization accounted for 47.3%. Many people also have visited emergency rooms at night or on holidays simply because they cannot take time off on weekdays.

Ambulances and emergency medical services are limited public resources. If the casual use of such services increases, it will be impossible to save other lives that could be saved. Local governments and hospitals have called for the appropriate use of these services, but there is a limit to what can be done by simply relying on the common sense of local residents.

Given that, some medical institutions have begun to effectively charge patients with minor symptoms for the use of emergency services.

Three major hospitals in Matsusaka, Mie Prefecture, have decided to collect ¥7,700, in principle, from patients with minor symptoms who are transported by ambulance from June this year.

These hospitals will apply additional fees by using the central government’s system in which ¥7,000 or more is charged to new patients — in addition to medical fees — if they receive services at large hospitals without written referrals from their primary-care doctors.

A nearby hospital has already introduced such a system, and the introduction has reportedly resulted in curbing the use of emergency services by people with minor symptoms.

However, the application of such additional fees is a measure taken under the pressure of necessity. Shouldn’t the central government move to revise the relevant law in the first place in order to allow medical institutions to collect fees from people who casually use emergency medical services?

Telephone consultation services have been established elsewhere in the nation for people who are not sure whether to make emergency calls. After listening to the callers, ambulance dispatches are requested for those in need of such assistance, or they are referred to medical institutions to receive treatment. Yet it cannot be said that these services have been fully utilized.

The spread of such consultation services will help reduce ambulance dispatches. The central and local governments must make efforts to expand these services and make them widely known.

(From The Yomiuri Shimbun, Feb. 11, 2024)