Overview of doctor‐staffed ambulance use in Japan: a nationwide survey and 1‐week study

Aim In Japan, standard prehospital care is provided by emergency medical services teams. Doctor‐staffed ambulances play a role in facilitating the immediate treatment of critically ill patients to increase the survival rates. However, little is known about their activities. We revealed the present situation of doctor‐staffed ambulances in Japan. Methods First, we surveyed all the fire departments in Japan and determined whether a doctor‐staffed ambulance was present within their district boundary. Second, we surveyed hospitals that operate doctor‐staffed ambulances in their system to list their activities during a 1‐week period. Results Of 133 hospitals that operated a doctor‐staffed ambulance, 73 (55%) replied to our questionnaire. Only 26 (36%) of them provided 24‐h ambulance deployment. Additionally, 51 (70%) of hospitals bore the operational costs of ambulances. Within 1 week, 345 doctor‐staffed ambulances were dispatched, but 97 (28%) were cancelled. In total, 62 patients (28%) were diagnosed with cardiac arrest, 48 (19%) with trauma or burns, 36 (15%) with stroke, and 22 (9%) with acute coronary syndrome; 159 (58%) were transferred to a tertiary emergency medical center. Conclusions Doctor‐staffed ambulances have the advantage of deployment at night and in urban areas compared to doctor‐staffed helicopters. Among the 73 hospitals that responded to the questionnaire, doctor‐staffed ambulances were dispatched almost as frequently as doctor‐staffed helicopters. However, doctor‐staffed ambulances did not receive adequate funding. Future data collection is necessary to determine the efficacy of doctor‐staffed ambulances among hospitals that operate this service.