Record-high Emergency Transports to Hospitals: How Can Strained Medical System Be Protected?

Editorial

15:23 JST, February 11, 2025

The number of patients transported to medical institutions as the result of emergency calls continues to increase. The emergency medical care system must be protected so that lives that could have been saved will not be lost.

In 2023, there were about 7.64 million ambulance dispatches nationwide and about 6.64 million people were transported to hospitals that way, both record highs. The average time required from an emergency call to the arrival of an ambulance at the scene was the second longest ever at 10 minutes.

About 60% of the people transported were elderly. The number of people transported for emergency medical care will inevitably increase in the future, due to the aging of the population. How to maintain an emergency medical care system that is strained is a nationwide issue.

In principle, it is free to use an ambulance. A government panel of experts proposed in 2016 that careful debate is necessary over whether to charge for the use of ambulances. However, half of the people transported have mild symptoms that do not require hospitalization.

An ambulance should be called without hesitation if the situation is believed to be highly urgent at the time of the emergency call, even in cases that are not ultimately serious, such as heatstroke or a mochi rice cake being stuck in the throat.

However, people should refrain from casually using ambulances for reasons like “I feel itchy because I was bitten by a mosquito” or “I got a paper cut on my finger.”

The Ibaraki prefectural government has instituted a system in which hospitals collect in principle at least ¥7,700 as a “treatment of patients’ choice” fee from people who are transported to major hospitals for symptoms with low urgency. This kind of fee is also collected from people who visit a hospital without a letter of referral.

Last year, the three core hospitals in Matsusaka, Mie Prefecture, began collecting the “treatment of patients’ choice” fee. As a result, ambulance dispatches decreased by as much as 20% in three months from a year earlier, according to the city. Moves to introduce the same system may spread in other local governments and hospitals around the country in the future.

However, using the “treatment of patients’ choice” fee system — which is intended to alleviate the concentration of patients at large hospitals — to promote the proper utilization of ambulances is a last resort forced by necessity. The central government should not just leave it to local governments to handle this issue; it should examine the appropriateness of charging such a fee, based on the current situations and issues in the regions where the system has been set up.

Although there is a “#7119” telephone consultation service for people who are not sure whether to make an emergency call, some prefectures have not introduced it yet. Efforts should be made to expand the service nationwide and promote its use as soon as possible.

A communication system between emergency medical teams and hospitals must also be put in place. Currently, paramedics call individual hospitals to coordinate where to transport people. But, if a hospital is unable to accept a patient, the same conversations are repeated with another hospital.

Some local governments have introduced a system that allows emergency medical teams and multiple nearby hospitals to share online images of a patient’s condition and affected area, and then swiftly decide where they should be accepted. It is hoped that the percentage of lives that are saved will improve by streamlining emergency transports.

(From The Yomiuri Shimbun, Feb. 11, 2025)