From this post, I will answer 30 questions that I wrote on the second post!
In this post, I will focus on general information about the issue of ambulance use.I will answer questions 1, 2, 3, 6, 11, 13, 14, 17, and 24.
>What’s the ambulance charge problem? (Q1)
In Japan, ambulance fee is set free, for everyone can receive medical care equally. However, in recent years, the number of people who use the ambulance as a taxi and they don’t have any serious problems is increasing. Because of this tendency, medical care tends not to reach the people who need help. Therefore, some people (mainly doctors) argue the necessity of charging for an ambulance.
>What’s so problematic? (Q2)
This issue became so problematic because this is a kind of serious choice to choose the right for human health or the importance of saving human lives. If people choose the former idea, the Japanese medical system will collapse. However, on the other hand, if we choose the latter one, people who can take medical care will be limited.
Since both sides are so important, this issue became so problematic.
>In this problem, who is involved? (Q3)
In this problem, a lot of kinds of people or organizations have relevance. For example, doctors and older patients. Needless to say, because of the inappropriate use of an ambulance, doctors worry about the quality of medical care. If they spare time for people who have only mild disease, they cannot pay enough attention to the patients who have a serious disease. As for the elderly people, I used data that shows that most are cases of inappropriate use of an ambulance is caused by older patients. They don’t have access to go to the hospital or they feel lonely so they call an ambulance as a taxi. Other than that, nurses, firefighters, parents of small children, police, local government, or other people/organizations are involved in this problem.
>How big the effect of overuse of ambulances by patients who are not so seriously injured? (Q6)
Since the number of ambulances is limited in each region, if people who have mild disease use ambulances there is a possibility of leaving people who have serious diseases to die. Also, it took a lot of money to move an ambulance for one call. It may bring the local government economical corruption.
>How change this issue according to ages? (Q11)
>How change the number of calling an ambulance? (Q13)
In this section, I will answer two questions; Q11 & 13. At first, I will focus on question 13. According to a study which was conducted by the Ministry of Internal Affairs and Communications in Japan, the number of calls for an ambulance is increasing year by year. There are some reasons for this result like the increase of elderly people because of theJapanese aging society or the increase in the number of people who have a heart disorder. However, “increase the number of people who have mild diseases” ranked in the top 3 and it occupies 38.4% of the total. It is so problematic!
Then, let’s move on to question 11; how change this issue according to ages? Although I could not find accurate data of the number of inaccurate ambulance use, I found an article which says that the Ministry of Internal Affairs and Communications started to collect the data of inappropriate use of ambulance since 2019. Until 2018, they don’t collect the data but this decision means that there are many cases that ambulances are not used efficiently. In fact, it is said that about 1 out of 3 people who come to the hospital via an ambulance have mild disease.
>Why people use an ambulated a taxi? (Q14)
According to an article, these are thought to be a reason why people use ambulances as a taxi.
•Because it’s free.
•It is natural that people use an ambulance even with a small injury because they pay for medical insurance.
•By using an ambulance, people don’t have to wait for being diagnosed.
•simply feel loneliness.
•doctor diagnoses make patients feel relief.
•There isn’t any other way to go to the hospital.
•People don’t know which hospital they should go to.
-reference-
①7割超の国民「軽症ゆえ救急車を使わず、自分で病院を受診せよ」との勧奨を受け入れ―内閣府世論調査: GemMed: データが拓く新時代医療. GemMed. (2017, September 12). https://gemmed.ghc-j.com/?p=15699.
②救急車の適正利用をお願いします. 救急車の適正利用をお願いします 新潟市. (n.d.). https://www.city.niigata.lg.jp/smph/kurashi/bohan/shobo/syokai/shinai_syobo/shobo_chuo/oshirase/tekiseiriyou.html.
>How important for the people who have a serious disease the time is? (Q17)
Do you know the golden hour principle? It’s a graph that shows rough standards of heart-stopping, respiration stop, and massive blooding. Here is that graph.
According to this principle, if patients who have a serious disease can arrive at the hospital in the first hour, the possibility of their survival will dramatically increase. So, the first hour is called a golden hour for critical patients.
However, if many people use ambulances easily, the number of ambulances that have to go to help critical patients will be limited.
>Dose this issue linked to the PA agreement in Japan? (Q22)
Do you know the PA agreements in Japan? This might be a unique system which exists only in Japan. PA stands for “pumper” and ”ambulance.” So the PA agreement means that if people call for an ambulance as an emergency of their life, pumpers also come to check what’s going on there. In fact, it is not so rare that pumper and ambulance are parked together. Therefore, even though it was a small ache or disease, once a person calls for an ambulance, it automatically means that the pumper has to go the site. So, the problem of inappropriate use of ambulance surely affects not only people who work at the hospital but also firehouse or firefighters.
-reference-
小野市消防本部. (n.d.). https://ono119.jp/?id=1093.
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