title: Ambulance Dispatches From Unaffected Areas After the Great East Japan Earthquake: Impact on Emergency Care in the Unaffected Areas.
abstract: OBJECTIVE
  Although dispatching ambulance crews from unaffected areas to a disaster zone is inevitable when a major disaster occurs, the effect on emergency care in the unaffected areas has not been studied. We evaluated whether dispatching ambulance crews from unaffected prefectures to those damaged by the Great East Japan Earthquake was associated with reduced resuscitation outcomes in out-of-hospital cardiac arrest (OHCA) cases in the unaffected areas.
  
  
  METHODS
  We used the Box-Jenkins transfer function model to assess the relationship between ambulance crew dispatches and return of spontaneous circulation (ROSC) before hospital arrival or 1-month survival after the cardiac event.
  
  
  RESULTS
  In a model whose output was the rate of ROSC before hospital arrival, dispatching 1000 ambulance crews was associated with a 0.474% decrease in the rate of ROSC after the dispatch in the prefectures (p=0.023). In a model whose output was the rate of 1-month survival, dispatching 1000 ambulance crews was associated with a 0.502% decrease in the rate of 1-month survival after the dispatch in the prefectures (p=0.011).
  
  
  CONCLUSIONS
  The dispatch of ambulances from unaffected prefectures to earthquake-stricken areas was associated with a subsequent decrease in the ROSC and 1-month survival rates in OHCA cases in the unaffected prefectures.
authors.affiliation: 1Department of Health Services Management and Policy,Kyushu University Graduate School of Medical Sciences,Fukuoka,Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Hagihara
authors.affiliation: 1Department of Health Services Management and Policy,Kyushu University Graduate School of Medical Sciences,Fukuoka,Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Onozuka
authors.affiliation: 2Department of Emergency and Critical Care Center,Kyushu University Hospital,Fukuoka,Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagata
authors.affiliation: 3Advanced Critical Care and Emergency Center,Yokohama City University Medical Center,Kanagawa,Japan.
authors.forename: Takeru
authors.initials: T
authors.lastname: Abe
authors.affiliation: 4Shimonoseki-City Welfare Department,Yamaguchi,Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: 1Department of Health Services Management and Policy,Kyushu University Graduate School of Medical Sciences,Fukuoka,Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nabeshima
mesh_terms: D000552:Ambulances / Q000706:statistics & numerical data*; D004189:Disaster Planning / Q000379:methods* / Q000706:statistics & numerical data; D055866:Earthquakes / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards*; D062406:Fukushima Nuclear Accident; D006801:Humans; D007564:Japan / Q000453:epidemiology; D012151:Resuscitation / Q000401:mortality / Q000706:statistics & numerical data; D016019:Survival Analysis; D013997:Time Factors
keywords: disaster planning; emergency medical services; epidemiological methods