ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 37
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Hospitals’ ability to accept patients transported by
ambulance during the COVID-19 pandemic in Japan
Dr Shinto Ando1, Ms Misa Tomono2, Toshikazu Abe3,4, Yasuharu Tokuda5
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Minami Seikyo General Hospital, 2The Jikei University School of Medicine, 3Department of Emergency
and Critical Care Medicine, Tsukuba Memorial Hospital, 4Health Services Research and Development
Center, University of Tsukuba, 5Muribushi Project for Okinawa Residency Programs Okinwakinawa
Background
During the COVID-19 pandemic in Japan, there was public criticism of the healthcare system’s
response when many ambulance patients could not be transported to hospitals in a timely manner
because many hospitals refused acceptance. This study examined pandemic-related factors that
impacted long transport time and/or hospital refusals of ambulance patients in Tokyo.
Methods
Daily case data of ambulance transports during the COVID-19 outbreak from 1 January to 31
December 2020 were collected from the Tokyo Metropolitan Fire Department. From that data, the
number of cases with a long transport time of more than 30 minutes and the number of cases
with four or more hospital refusals of acceptance were extracted. Hospitalisation data about newly
identified COVID-19 cases and severe COVID-19 cases were collected from the Tokyo Metropolitan
Government. Seasonal autoregressive integrated moving average (SARIMA) modelling with COVID-19
cases as the exogenous factor was employed to investigate factors related to cases with long
transport time or hospital refusals.
Results
Of a total 625,639 ambulance transport cases during a one-year period, there were 36,823 cases with
an ambulance transport time of more than 30 minutes and 40,840 cases with four or more hospital
acceptance refusals. The mean transport time was 11.39 minutes, while the longest transport time
was 420 minutes. The highest number of acceptance refusals was 139. Both ambulance transport
time and acceptance refusal were significantly associated with seasonality. The number of severe
COVID-19 cases in Tokyo was significantly associated with transportation time, with an adjusted beta
of 0.0141 (95% CI: 0.006, 0.022). There was no significance seen between transport time or hospital
refusals and newly identified COVID-19 cases.
Conclusion
The ability of hospitals to accept patients transported by ambulance was reduced by the increased
number of severe COVID-19 cases.
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