Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study

Abstract

ObjectivesSustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster.DesignThis research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality.SettingThe residents in Kawauchi Village, Fukushima, Japan were forced to evacuate after the 2011 Fukushima disaster. As the radiation dose was an acceptable level, the residents began the process of repopulation in April 2012.ParticipantsThis study included patients transported by EMS from January 2009 to October 2015. Patients transported during the evacuation period (from March 2011 to March 2012) were excluded.ResultsA total of 781 patients were transferred by EMS (281 patients before the disaster, 416 after repopulation and 84 during the evacuation period). A Bayesian time series analysis revealed an increase in total EMS time, from the first request call to arrival at a hospital of 21.85 min (95% credible interval 14.2–29.0, Bayesian one-sided tail-area probability p=0.001). After the disaster, 42.3% of patients were transported to a partner hospital.ConclusionsTotal EMS time increased after repopulation of the area affected because of a massive number of hospital closures. Proactive partnerships would be a possible countermeasure in the affected areas after a major disaster.

Impact of lifting the mandatory evacuation order after the Fukushima Daiichi Nuclear Power Plant accident on the emergency medical system: a retrospective observational study at Minamisoma City with machine learning analysis

“…Furthermore, the evacuation order in Odaka Ward affected the Haramachi Ward in the non-evacuated areas (figure 1). Past studies have suggested that EMS response times in evacuated areas may be longer than that in non-evacuated areas after the evacuation order is lifted, [23][24][25][26] and the observed finding is not consistent with these previous studies. 26…”

“…18 23 Additionally, the sociodemographic characteristics of the local population have changed significantly from predisaster levels, as most of the returnees are elderly and reconstruction workers. [23][24][25] This dynamic shift in the evacuation zone, deterioration of the healthcare delivery system and demographic changes may have affected the EMS as well.…”

Home-visit rehabilitation in a repopulated village after the Fukushima nuclear disaster

“…cal resources, and access to healthcare is affected by cost, distance to facilities, and information barriers, in addition to the limited availability of therapists 6,7) . Disaster evacuation and repopulation are known to be complex situations that affect access to various healthcare services, such as emergency medical services 8) . However, there is a lack of information regarding the provision of rehabilitation in limitedresource areas, the distance to the patient's home, the number of staff available, and the frequency of rehabilitation activities.…”

Evaluation of the emergency medical system in an area following lifting of the mandatory evacuation order after the Fukushima Daiichi Nuclear Power Plant accident

“…[ 10 ] Most of the returning residents are the elderly, making resumption of medical systems in the former evacuation areas a priority. [ 24 , 25 ] Health care systems in the affected areas remain heavily affected since many hospitals in the area were forced to close and remain closed even after the evacuation orders were lifted. [ 23 ] Notably, the situations of emergency transport in the area where the evacuation order was lifted have been shown to be different from those before the disaster, leading to the delay in EMS time.…”