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Present situation of emergency outpatient care at a rural hospital in Japan.

Terashima S
Proceedings of the VII International Congress of Rural Medicine, September 17-21, Salt Lake City, Utah. International Association of Agricultural Medicine, 1978 Sep; :100-105
Problems associated with providing emergency outpatient care in rural areas of Japan were discussed. Providing emergency care in rural communities is considered to be one of the most serious medical care problems in Japan. The major reasons contributing to the problem are that many hospitals are reluctant to provide emergency care because insurance remunerations are very low, many hospitals find it difficult to provide emergency care because their subsidies are too low, and the number of physicians available to provide emergency care is very small. Most of the available physicians are specialists and can treat emergency cases only if they happen to fall within their area of specialization. The experience of Saku Central Hospital in providing emergency care was described. The hospital is located in Minami-Saku District, a predominantly rural area with a population of around 100,000. In 1977 more than 10,000 patients received emergency outpatient treatment at nights and on holidays. The largest percentage of cases, 35 percent, was in the 0 to 4 year age group. Except for the 20 to 30 year age group, male patients predominated. The preponderance of female patients in the 20 to 30 year group was attributed to delivery and complications associated with pregnancy. About 67 percent of the emergency outpatients consisted of pediatric, internal medicine, and surgical cases. Pediatrics was especially high, coming in at 45 percent in 1977, thus giving just cause to insist that pediatricians always be available for emergency care. Approximately 15 percent of the emergency patients seen at night or on holidays were hospitalized, versus 2 percent of those seen on weekdays. The author notes that conventional medical school education does not adequately prepare physicians for providing emergency medical treatment. To remedy this, the hospital has instituted a program that trains paramedics and physicians in providing emergency care.
NIOSH-Grant; Grants-other; Medical-treatment; Health-care-personnel; Health-care-facilities; Emergency-treatment; Age-factors; Sex-factors; Clinical-diagnosis; Training
Prev Med & Environmental Hlth University of Iowa Inst/agric Med & Environ Hlth Iowa Oakdale, Iowa 52319
Publication Date
Document Type
Conference/Symposia Proceedings
Funding Amount
Funding Type
Fiscal Year
Identifying No.
Priority Area
Other Occupational Concerns; Grants-other
Source Name
Proceedings of the VII International Congress of Rural Medicine, September 17-21, Salt Lake City, Utah
Performing Organization
University of Iowa, Iowa City, Iowa
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division