Hori Shingo
Emergency and Critical Care Medicine, Keio University, School of Medicine, Tokyo, Japan.
Keio J Med. 2010;59(4):131-9. doi: 10.2302/kjm.59.131.
There have been few reports published in English on emergency medicine (EM) in Japan; the main reason for this is that the concept of EM was different in Japan from that in western countries. In the 1960s, legislation was passed in Japan that implemented emergency medical services, and emergency hospitals were designated by the government. There were no emergency medicine specialists, and so surgeons/physicians without specialist training in emergency medicine provided care to emergency patients (the multispecialist-type model). The Japanese Association for Acute Medicine (JAAM), an academic society for emergency physicians, was founded in 1973. In its pioneering days, this association focused mostly on trauma/burn care and also influenced policymaking. In 1977, the government built emergency medical service centers (the ICU-type model) and reorganized all emergency medical facilities into three levels. With the aging of society, the number of non-trauma patient! s presenting at hospitals, especially in the elderly population, has increased and has resulted in some cases of refusal by hospitals to accept emergency patients. A new postgraduate medical education curriculum was legislated in 2004 that mandated EM training for all postgraduates and encouraged reinforcement of emergency departments in teaching hospitals. The JAAM established a committee to promote the ER-type model of EM in 2003. By 2007, more than 150 JAAM-affiliated hospitals had implemented this type of EM. In conclusion, emergency medicine in Japan is currently based on a mixture of three models: the multispecialist-type, the ICU-type and the ER-type models.
关于日本急诊医学（EM）的英文报道很少；主要原因是日本的急诊医学概念与西方国家不同。20世纪60年代，日本通过了实施紧急医疗服务的立法，政府指定了急诊医院。当时没有急诊医学专科医生，因此没有接受过急诊医学专科培训的外科医生/内科医生为急诊患者提供治疗（多专科类型模式）。日本急性医学协会（JAAM）是急诊医生的学术团体，成立于1973年。在其开创初期，该协会主要专注于创伤/烧伤护理，也对政策制定产生了影响。1977年，政府建立了紧急医疗服务中心（重症监护病房类型模式），并将所有紧急医疗设施重新划分为三个级别。随着社会老龄化，医院里非创伤患者的数量，尤其是老年人群中的数量有所增加，导致在某些情况下医院拒绝接收急诊患者。2004年通过了一项新的研究生医学教育课程，要求所有研究生接受急诊医学培训，并鼓励加强教学医院急诊科的建设。JAAM于2003年成立了一个委员会来推广急诊医学的急诊室类型模式。到2007年，超过150家隶属于JAAM的医院采用了这种急诊医学模式。总之，日本的急诊医学目前基于三种模式的混合：多专科类型、重症监护病房类型和急诊室类型模式。
