Impact in the emergency medical system due to the scale reduction of regional core hospitals

Abstract

Background: Owing to the scale reduction of the regional core hospital, which accepts 1,000 ambulances annually, the acceptance of ambulances has been restricted from April 2019.

Objective: To assess the impact in the regional emergency medical system caused by the scale reduction of regional core hospitals.

Method: The 4,532 ambulance transport cases in 2018 were defined as the pre group, and the 4,514 ambulance transport cases in 2019 were defined as the post group. The am-bulance activity time, severity, number of acceptance negotiations, and destinations were examined and compared.

Results: Hospital admission time did not change, remaining at 53 minutes in both the pre group and the post group (p=0.93). The on-site stay time was decreased from 21 minutes in the pre group to 19 minutes in the post group (p<0.001). Extraterritorial transport increased significantly (p<0.001) from 3,053 (67.4%) in the pre group to 3,513 (77.9%) in the post group. The number of cases transferred to the tertiary emergency medical in-stitution increased significantly (p<0.001) from 750 (16.5%) in the pre group to 1,016 (22.5%) in the post group.

Conclusion: With the scale reduction of regional core hospitals, the number of out-of-region transportations and transportations to tertiary emergency medical institu-tions increased, but no extension of hospital accommodation time was allowed, and the time spent at the site was shortened.