2011 年 5 巻 4 号 p. 95-100
We have conducted the situation analysis of emergency division of the DPC based acute care hospitals during 1st and 31st October 2006. The studied hospitals were 180 facilities that contracted with our research team for this study. Each participant hospital was required to register the patients who used the emergency division during 1st to 31st October 2006. We differentiated the cases into three types; primary case, secondary case and tertiary case. Furthermore, we distinguished the hospitals into two types; with and without emergency care centers. Based on this dataset, we have conducted the descriptive analyses concerning the patient type and primary diagnosis of tertiary patients. Contrary to the governmental policy for organization of emergency services, although the facilities with the emergency care center accepted more tertiary cases (88.8 cases per month v.s 32.6; 15.8% vs 4.2%), primary cases represented about 70% as like as facilities without emergency care center. There were little differences in the disease structures of accepted patients between both types. Cerebro-vascular diseases (i.e., cerebral infarction, cerebral hemorrhage, SAH), ischemic heart diseases (AMI and angina pectoris), poisoning, hip and pelvic fractures, pneumonia were common diseases and injuries. In order to realize a balanced emergency care system, the governance power of Regional Health Care Plan must be strengthened.