徳島県西部地域における救急医療の現状と課題

A total of 7，747 patients were treated in the Emergency Outpatient Department of Tokushima Prefectural Miyoshi Hospital in 2011 （primary :64％, secondary :21％, and tertiary emergency care : 4％）. The number of emergency cases accepted by ambulance was 1，841, showing an increasing trend. The patients were transported from areas that are governed by the Miyoshi cross-regional association in 84％ and the Western I medical region in 15％. There were 21 emergency patients who were not accepted by the hospital, and the acceptance rate of ambulance cases accounted for 99．7％ in Miyoshi Hospital. On the other hand, the total number of patients who required an ambulance was 1，958 in all areas of the Miyoshi cross-regional association in 2011, and they were transported to Miyoshi Hospital in 78％ of cases, hospitals in areas governed by the cross-regional association in 10％, and hospitals in other regions in 12％. Four patients were transported by helicopter （hospital discharge in 2 and hospital admission in 2 patients）. Thus, 93．2％ of emergency cases were handled within the Western II medical region, which is relatively high compared to other regions in the prefecture, and most of the cases were dealt with by Miyoshi Hospital. However, physicians have an increasing burden due to frequent night shifts, overtime duties, and the adoption of the on-call system. The shortage and uneven distribution of physicians must be resolved.