Abstract
In recent years, the number of graduates from medical school who become pediatricians has decreased in Japan. Consequently, there are not enough pediatricians seeing children who visit hospital after office hours. Since pediatricians in ex-national sanatorium like our hospital are required to see these patients, we started a 24 hour-acceptance system for pediatric patients involving four pediatricians and eight non-pediatric doctors (generalists) from December, 2004. In this system, pediatricians are on call when generalists are on night duty. We compared the number of children who visited hospital after office hours before and after the system started. The number was 47.5+/-13.5 (mean+/-SD) per month from January to August in 2004, and it increased significantly to 144.8+/-40.4 per one month from January to August in 2005 (p=0.0117). However, the number of patients who were seen by generalists did not increase significantly (21.3+/-29.5 v. s. 29.5+/-9.15, p=0.1083). The number of patients who were admitted to the hospital did not increase significantly, also. The increase in the number of children on Sundays, Saturdays and holidays was significant. One pharmacist and one nurse were added to support this system. In response to announcing this system to the community, the press reported that the citizens were feeling secure because of the start of the system. Another effect of starting the system has been that the number of children who visit hospital during opening hours has increased, which is profitable to the hospital. In addition, for not only pediatricians but also generalists and nurses, there was an apparent effect to recover medical skills to see pediatric patients, which had been limited in a conventional national sanatorium. One year after we started this system, all pediatricians, including us in Tsugaru community with a population of approximately 400, 000, established a 24-hr medical-care system for children, and we have to be involved in the system for several days a month. Although this was another burden to our pediatricians, they did not oppose working for the system. In conclusion, it was helpful for the reinvigoration of the activity of the hospital to be enthusiastic about meeting regional medical needs such as acceptance of pediatric patients visiting hospital after office hours.
