Implementation of US-style Emergency Medicine in Japan

Hori, Shingo; Ohta, Syoichi; Ohashi, Noriyoshi; Kimura, Akio; Kohno, Hiroyuki; Takino, Masaya; Terasawa, Hidekazu; Minowa, Yoshiyuki; Morishita, Yuka; Akashi, Katsuya; Yamamoto, Yasuhiro

doi:10.3893/jjaam.18.644

Cited by 13 publications

(3 citation statements)

References 12 publications

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“…Regarding the issues surrounding emergency medical care, support measures are required to raise the level of response capability of secondary emergency medical institutions and enable them to accurately fulfill their roles [ 1 , 3 ]. In addition, some have noted that policy consideration should be given to the current situation in which physicians with non-emergency specialties are broadly responsible for emergency services [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, the “emergency center-type emergency medical care model” (emergency physicians specially trained to deal with critically ill patients, where tertiary medical institutes) and the “department-specific emergency medical care model,” unique to the country, have been the main models in operation for a long time [ 3 ]. The “ER-based emergency medicine model,” newly added to Japan’s emergency medical care delivery system, is the third model [ 3 ]. Since 2004, ER-based emergency medicine has been the subject of active discussion at academic conferences in Japanese Association for Acute Medicine (JAAM).…”

Section: Introductionmentioning

confidence: 99%

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The current status of emergency departments in secondary emergency medical institutions in Japan: a questionnaire survey

et al. 2023

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Background While emergency medicine (ER)-based emergency care is prevalent in many countries, in Japan, the “department-specific emergency care model” and the “emergency center model” are mainstream. We hypothesized that many secondary emergency medical institutions in Japan have inadequate systems. Using a questionnaire, we investigated the status of and problems in the emergency medical services system in secondary emergency medical institutions in Japan. Until date, there has not been an exhaustive survey of emergency facilities on a countrywide scale. The main objective of this study was to investigate problems in the Japanese emergency medical services system and thereby improve optimal care for emergency patients. Results A nationwide questionnaire survey involving 4063 facilities (all government-approved emergency medical facilities certified by prefectural governors) in Japan was conducted. Of the facilities that responded, all secondary emergency facilities were included in the analysis. Responses from 1289 facilities without a tertiary emergency medical care center were analyzed. Among them, 61% (792/1289) had ≤ 199 beds, and 8% were emergency department specialty training program core facilities. Moreover, 42% had an annual patient acceptance number of ≤ 500, 19% did not calculate the number of acceptances, 29% had an acceptance rate of ≥ 81%, and 25% had an acceptance rate of 61–80%. Pregnant women (63%) and children (56%) were the major types of patients that affected the acceptance rate. Factors affecting facilities with a response rate of 81% or higher were “hospitals designated for residency training” and “facilities making some efforts to improve the quality of emergency care and the emergency medical system” (logistic analysis, P < .001). Conclusion Relevant authorities and core regional facilities should consider and implement specific measures for regions and hospitals with a shortage of emergency medicine specialists and physicians (e.g., development of ER-based emergency medicine and provision of education). This study may lead to further improvement in the optimal care of emergency patients through the nationwide establishment of the proposed measures as well as through grouping and integrating the structures and systems in emergency and other medical facilities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The current status of emergency departments in secondary emergency medical institutions in Japan: a questionnaire survey

et al. 2023

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“…A section of JAAM has been working on developing and promoting the "ER-type" or the US/UK/Australian/Canadian-style emergency medicine system in Japan since 2003. 17 The committee named the US-style model the "ERtype" model after the popular TV drama ER to make the model familiar to the common citizen. The committee also defined the model as that in which the emergency physician provides care as the "first doctor" for emergency patients with different degrees of acuity and with different organ involvement, irrespective of the patients' age and sex.…”

Section: Er-type Emergency Medicinementioning

confidence: 99%

Emergency Medicine in Japan

Hori

2010

Keio J. Med.

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There have been few reports published in English on emergency medicine (EM) in Japan; the main reason for this is that the concept of EM was different in Japan from that in western countries. In the 1960s, legislation was passed in Japan that implemented emergency medical services, and emergency hospitals were designated by the government. There were no emergency medicine specialists, and so surgeons/physicians without specialist training in emergency medicine provided care to emergency patients (the multispecialist-type model). The Japanese Association for Acute Medicine (JAAM), an academic society for emergency physicians, was founded in 1973. In its pioneering days, this association focused mostly on trauma/burn care and also influenced policymaking. In 1977, the government built emergency medical service centers (the ICU-type model) and reorganized all emergency medical facilities into three levels. With the aging of society, the number of non-trauma patients presenting at hospitals, especially in the elderly population, has increased and has resulted in some cases of refusal by hospitals to accept emergency patients.

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