[Survey of analytical work done for drugs at the emergency and critical care centers equipped with high-performance instruments provided by the Ministry of Health and Welfare (at present: Ministry of Health, Labour and Welfare) in fiscal 1998].

A questionnaire was sent to 73 emergency and critical care centers where high-performance instruments for analyzing drugs and chemicals were provided by the Ministry of Health and Welfare (currently Ministry of Health, Labour and Welfare) in fiscal 1998. 52 centers (71.2%) responded to the questionnaire. Among these, the instruments have been in operation at 36 centers. This means that analytical work has been performed in at least 49.3% (36/73) of facilities with the instruments. A positive correlation was observed between the annual number of patients tested for drugs and chemicals and analytical work hours at the 36 facilities. The results indicated that 150 cases may be tested for drugs and chemicals in a year on the condition that 100 hours a month of analytical work are secured, and 200 or more cases may be tested if 200 hours a month are secured. As for the running costs required for the operation of the instruments, the instrument maintenance and repair cost was estimated at 2 million yen a year, and it was calculated that 100 cases could be handled with a maximum annual supply expense of 1 million yen and 150 cases could be handled with a maximum annual supply expense of 2 million yen. These results suggest that the instrument running cost would be fully covered at nationwide emergency and critical care centers if the additional 5,000 NHI points (1 point = 10 yen) for hospital admission, which is approved for advanced emergency and critical care centers, were applicable to all facilities. Among the 36 facilities, the implementation of analysis varied for each of the 15 toxic substances recommended for analysis by the Japanese Society for Clinical Toxicology. Further research will be necessary to investigate and assess the frequency of analysis requests and combination of simple qualitative and instrumental analyses for each of the 15 substances, in order to evaluate the approach to the 15 substances in analytical work.