Yamanouchi Satoshi, Ishii Tadashi, Morino Kazuma, Furukawa Hajime, Hozawa Atsushi, Ochi Sae, Kushimoto Shigeki
Prehosp Disaster Med. 2014 Dec;29(6):614-22. doi: 10.1017/S1049023X14001095. Epub 2014 Oct 22.
When disasters that affect a wide area occur, external medical relief teams play a critical role in the affected areas by helping to alleviate the burden caused by surging numbers of individuals requiring health care. Despite this, no system has been established for managing deployed medical relief teams during the subacute phase following a disaster. After the Great East Japan Earthquake and tsunami, the Ishinomaki Medical Zone was the most severely-affected area. Approximately 6,000 people died or were missing, and the immediate evacuation of approximately 120,000 people to roughly 320 shelters was required. As many as 59 medical teams came to participate in relief activities. Daily coordination of activities and deployment locations became a significant burden to headquarters. The Area-based/Line-linking Support System (Area-Line System) was thus devised to resolve these issues for medical relief and coordinating activities.
A retrospective analysis was performed to examine the effectiveness of the medical relief provided to evacuees using the Area-Line System with regards to the activities of the medical relief teams and the coordinating headquarters. The following were compared before and after establishment of the Area-Line System: (1) time required at the coordinating headquarters to collect and tabulate medical records from shelters visited; (2) time required at headquarters to determine deployment locations and activities of all medical relief teams; and (3) inter-area variation in number of patients per team.
The time required to collect and tabulate medical records was reduced from approximately 300 to 70 minutes/day. The number of teams at headquarters required to sort through data was reduced from 60 to 14. The time required to determine deployment locations and activities of the medical relief teams was reduced from approximately 150 hours/month to approximately 40 hours/month. Immediately prior to establishment of the Area-Line System, the variation of the number of patients per team was highest. Variation among regions did not increase after establishment of the system.
This descriptive analysis indicated that implementation of the Area-Line System, a systematic approach for long-term disaster medical relief across a wide area, can increase the efficiency of relief provision to disaster-stricken areas.
当影响广泛区域的灾害发生时,外部医疗救援团队通过帮助减轻因需要医疗护理的人数激增所造成的负担,在受灾地区发挥着关键作用。尽管如此,在灾害后的亚急性期,尚未建立管理已部署医疗救援团队的系统。东日本大地震和海啸过后,石卷医疗区是受灾最严重的地区。约6000人死亡或失踪,约12万人被紧急疏散至约320个避难所。多达59支医疗队参与救援活动。活动和部署地点的日常协调给总部带来了巨大负担。因此,设计了区域/线路连接支持系统(区域 - 线路系统)来解决医疗救援和协调活动中的这些问题。
进行回顾性分析,以检验使用区域 - 线路系统向撤离人员提供医疗救援在医疗救援团队和协调总部活动方面的有效性。在区域 - 线路系统建立前后比较以下各项:(1)协调总部从访问的避难所收集和整理医疗记录所需的时间;(2)总部确定所有医疗救援团队的部署地点和活动所需的时间;(3)每个团队患者数量的区域间差异。
收集和整理医疗记录所需的时间从约每天300分钟减少到70分钟。总部整理数据所需的团队数量从60个减少到14个。确定医疗救援团队的部署地点和活动所需的时间从约每月150小时减少到约40小时。就在区域 - 线路系统建立之前,每个团队患者数量的差异最大。系统建立后各区域间的差异没有增加。
这项描述性分析表明,区域 - 线路系统(一种跨广泛区域进行长期灾害医疗救援的系统方法)的实施可以提高向受灾地区提供救援的效率。