The impact of an emergency telephone consultation service on the use of ambulances in Tokyo.
BACKGROUND
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 44,689, 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.


CONCLUSIONS
To date, the emergency telephone consultation service has contributed to the appropriate use of ambulances and a reduction of its cost in Tokyo.
Morimura
Naoto
N
Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan. molimula@r6.dion.ne.jp
Aruga
Tohru
T
Sakamoto
Tetsuya
T
Aoki
Noriaki
N
Ohta
Sachiko
S
Ishihara
Toru
T
Kushimoto
Shigeki
S
Ohta
Shoichi
S
Ishikawa
Hideki
H
D000552:Ambulances / Q000706:statistics & numerical data*; D003661:Decision Support Techniques; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019114:Remote Consultation; D018570:Risk Assessment; D012449:Safety; D013689:Telephone; D013997:Time Factors; D014041:Tokyo