Ohshige Kenji, Kawakami Chihiro, Kubota Katsuaki, Tochikubo Osamu
Department of Public Health, Yokohama City University School of Medicine, Yokohama, Japan.
Acad Emerg Med. 2005 Oct;12(10):932-40. doi: 10.1197/j.aem.2005.05.033.
In Japan, anyone can use an ambulance free of charge, but this policy may encourage unnecessary ambulance use.
To determine the user price that would reduce unnecessary ambulance use, without discouraging medically necessary ambulance use.
The study was conducted by means of a three-part self-administered questionnaire. The first part consisted of questions covering demographic variables such as respondent age, gender, family structure, and pretax annual household income. The second part was made up of contingent valuation questions on ambulance use. Respondents were presented hypothetical situations and prices and then asked whether they would call an ambulance. The last part consisted of general questions pertaining to the city ambulance system. Answers to the hypothetical questions were analyzed in relation to demographic characteristics of the respondents.
A total of 2,029 out of 3,363 recipients completed the questionnaire (response rate, 60.3%). Analysis of the responses indicated that the demand for ambulance service in serious situations is inelastic with respect to price, whereas the demand for ambulance service in nonserious situations is fairly elastic with respect to price. These data showed that a user charge of 190 dollars (20,000 yen) may be an acceptable price, i.e., the price that will reduce the number of ambulance calls by persons with nonserious conditions, but not by persons with serious conditions.
Introducing a user charge for ambulance service may improve efficiency of the service operation.
在日本,任何人都可以免费使用救护车,但这项政策可能会鼓励不必要的救护车使用。
确定能减少不必要的救护车使用,同时又不阻碍医疗必需的救护车使用的用户收费标准。
该研究通过一份三部分的自填式问卷进行。第一部分包括关于人口统计学变量的问题,如受访者年龄、性别、家庭结构和家庭税前年收入。第二部分由关于救护车使用的条件价值评估问题组成。向受访者呈现假设情况和价格,然后询问他们是否会叫救护车。最后一部分由与城市救护车系统相关的一般问题组成。针对假设问题的答案根据受访者的人口统计学特征进行分析。
3363名受访者中有2029人完成了问卷(回复率为60.3%)。对回复的分析表明,在严重情况下对救护车服务的需求对价格缺乏弹性,而在非严重情况下对救护车服务的需求对价格相当有弹性。这些数据表明,190美元(20000日元)的用户收费可能是一个可接受的价格,即能减少非严重病情患者拨打救护车的次数,但不会减少严重病情患者拨打救护车的次数的价格。
引入救护车服务用户收费可能会提高服务运营效率。