## Provision of Emergency Medical Systems

In fiscal year 2007, for the seventh consecutive year, the number of fatalities from traffic accidents has decreased. It was less than 6,000 persons for the first time in 54 years. There are many factors that have caused the number of fatalities to decrease in recent years. The provision of rescue and emergency medical systems is one of the major factors. On one hand, the demand for emergency medical care is increasing, however, on the other hand, reinforcements for emergency and rescue teams are in a difficult situation. Medical institutions that handle emergency patients are also decreasing, causing a delay in the average time taken by an ambulance to reach the site and the average time required for admission in medical institutions. In Fukushima Prefecture, eight cases in which medical institutions refused the admission of traffic accident casualties occurred in four medical institutions on 11 $ ^{th} $ November last year and six such cases occurred in five emergency and critical care centers in Osaka Prefecture on 2 $ ^{nd} $ January this year. In these cases, the emergency medical transportation service was not provided smoothly. Therefore, the provision of a smooth emergency transportation service and medical system has become a prime task. With this situation in mind, the “Research Group for the Coordination of Fire Institutions and Medical Institutions” was established in the Fire and Disaster Management Agency. A continuous study on how to collect information on admissions in medical institutions and how to transmit information from the fire service to medical institutions was carried out and an interim report was summarized in March 2008. Additionally, a “Review Meeting Regarding the Role of Emergency Medical Care in the Future” was held by the Ministry of Health, Labour and Welfare in December 2007, and it is to collect the information about the role of emergency and critical care medical services in the future. Concerned institutions are working in cooperation for the resolution of a number of issues to maintain the safety and security of citizens.

## Rapid increase in the demand for emergency services—Current situation and measures

The number of emergency cases reached 5,240,000 in 2006 and this number is increasing each year. Since 1996, the number of emergency cases increased by approximately 55% in 10 years. However, the number of rescue teams increased only by approximately 10% during the years 1996 to 2007 due to a severe financial condition of each fire headquarters.

During 2006, the national average time required by an ambulance to reach the site was 6.6 minutes, and the national average time required until admission in a medical institution from the point of knowledge of the accident was 32.0 minutes. In terms of the number of transportation staff by ambulances according to the kind of accidents, the number of traffic accidents that used to be stable is decreasing.

Transition of the number of emergency and rescue teams and of emergencies

Note 1 Source: The Fire and Disaster Management Agency

2 The number of emergency crew is the current number as of April 1 for every year.

3 The number of emergency cases is the number from January to December for each year.