The impact of an emergency telephone consultation service on the use of ambulances in Tokyo

Emerg Med J. 2011 Jan;28(1):64-70. doi: 10.1136/emj.2009.073494. Epub 2010 Jun 26.

Abstract

Introduction: The increasing demands made on emergency ambulance services contribute to inefficient, clinically inappropriate health care, and may delay the provision of emergency care to life-threatening cases. The hypothesis of this study was that the activity for the first year of operation of an emergency telephone consultation service contributed to a reduction in ambulance use in non-urgent cases and a decrease in the cost associated with despatching ambulances.

Methods: The numbers of ambulance use and the emergency hospitalisation of ambulance cases were compared before and after the introduction of the Tokyo Emergency Telephone Consultation Centre (the #7119 centre). Public awareness of the #7119 centre in each region of Tokyo and the cost related to despatching ambulances were also investigated.

Results: A total of 26,138 consultations was performed in the initial year. Compared with the previous year, the number of ambulance uses per 1 million people decreased (before 46,846, after 44,689, p<0.0001). The emergency hospitalisation rate (EHR) of ambulance cases increased significantly because of the decreased proportion of non-urgent cases (before 36.5%, after 37.8%, p<0.0001). There was a statistical correlation between the awareness rate in each region and the change of after-hours EHR in adults (R=0.333, p=0.025). The total cost related to despatching ambulances was reduced by approximately ¥678,000,000 (£4,520,000) in the initial year.

Conclusion: To date, the emergency telephone consultation service has contributed to the appropriate use of ambulances and a reduction of its cost in Tokyo.

Publication types

  • Comparative Study

MeSH terms

  • Ambulances / statistics & numerical data*
  • Decision Support Techniques*
  • Emergency Medical Service Communication Systems / statistics & numerical data*
  • Emergency Medical Services / methods
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Humans
  • Male
  • Remote Consultation*
  • Risk Assessment
  • Safety
  • Telephone
  • Time Factors
  • Tokyo