Kawakami Chihiro, Ohshige Kenji, Kubota Katsuaki, Tochikubo Osamu
Department of Public Health, Yokohama City University School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Japan.
BMC Health Serv Res. 2007 Jul 27;7:120. doi: 10.1186/1472-6963-7-120.
Unnecessary ambulance use has become a socioeconomic problem in Japan. We investigated the possible relations between socioeconomic factors and medically unnecessary ambulance calls, and we estimated the incremental demand for unnecessary ambulance use produced by socioeconomic factors.
We conducted a self-administered questionnaire-based survey targeting residents of Yokohama, Japan. The questionnaire included questions pertaining to socioeconomic characteristics, dichotomous choice method questions pertaining to ambulance calls in hypothetical nonemergency situations, and questions on the city's emergency medical system. The probit model was used to analyze the data.
A total of 2,029 out of 3,363 targeted recipients completed the questionnaire (response rate, 60.3%). Probit regression analyses showed that several demographic and socioeconomic factors influence the decision to call an ambulance. Male respondents were more apt than female respondents to state that they would call an ambulance in nonemergency situations (p < 0.05). Age was an important factor influencing the hypothetical decision to call an ambulance (p < 0.05); elderly persons were more apt than younger persons to state that they would call an ambulance. Possession of a car and hesitation to use an ambulance negatively influenced the hypothetical decision to call an ambulance (p < 0.05). Persons who do not have a car were more likely than those with a car to state that they would call an ambulance in unnecessary situations.
Results of the study suggest that several socioeconomic factors, i.e., age, gender, household income, and possession of a car, influence a person's decision to call an ambulance in nonemergency situations. Hesitation to use an ambulance and knowledge of the city's primary emergency medical center are likely to be important factors limiting ambulance overuse. It was estimated that unnecessary ambulance use is increased approximately 10% to 20% by socioeconomic factors.
在日本，不必要的救护车使用已成为一个社会经济问题。我们调查了社会经济因素与医疗上不必要的救护车呼叫之间的可能关系，并估计了社会经济因素导致的不必要救护车使用的增量需求。
我们针对日本横滨的居民进行了一项基于自填问卷的调查。问卷包括与社会经济特征相关的问题、关于假设非紧急情况下救护车呼叫的二分选择法问题，以及关于该市紧急医疗系统的问题。采用概率单位模型对数据进行分析。
3363名目标受访者中共有2029人完成了问卷（回复率为60.3%）。概率单位回归分析表明，一些人口统计学和社会经济因素会影响呼叫救护车的决定。男性受访者比女性受访者更倾向于表示在非紧急情况下会呼叫救护车（p<0.05）。年龄是影响假设中呼叫救护车决定的一个重要因素（p<0.05）；老年人比年轻人更倾向于表示会呼叫救护车。拥有汽车和对使用救护车的犹豫对假设中呼叫救护车的决定有负面影响（p<0.05）。没有汽车的人比有汽车的人更有可能表示在不必要的情况下会呼叫救护车。
研究结果表明，一些社会经济因素，即年龄、性别、家庭收入和拥有汽车，会影响一个人在非紧急情况下呼叫救护车的决定。对使用救护车的犹豫以及对该市主要紧急医疗中心的了解可能是限制救护车过度使用的重要因素。据估计，社会经济因素使不必要的救护车使用增加了约10%至20%。
