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A Home-Visiting Clinic Decreased the Emergency Transportation in Rural Japan: A Quasi-Experimental Approach.

Takaaki Ikeda1,2, Kemmyo Sugiyama2,3,4, Yusuke Tanoue4

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Home medical care, established in 2013, effectively reduced emergency transportations in Tome City. This initiative provided vital support for homebound patients, decreasing the need for ambulance services.

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emergency transportemergency transportationshome medical careprimary careretrospective quasi-experiment

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Area of Science:

  • Gerontology
  • Public Health
  • Health Services Research

Background:

  • Tome City, Japan, has a significant aging population (35.5% in 2020).
  • Emergency transportation utilization in aging populations presents public health challenges.
  • Assessing interventions to support homebound elderly individuals is crucial.

Purpose of the Study:

  • To evaluate the impact of a home-visiting clinic on emergency transportation rates.
  • To determine the effectiveness of home medical care for homebound patients.
  • To analyze trends in emergency transportations before and after clinic establishment.

Main Methods:

  • Retrospective observational study in Tome City.
  • Quasi-experimental approach using private practice data.
  • Calculation of the standardized emergency transportations due to sudden illness ratio (SER) compared to national data, adjusted for age.

Main Results:

  • The SER in Tome City was 88.2% (2011) and 89.6% (2012) prior to the clinic's establishment.
  • Following the clinic's introduction in 2013, the SER showed a consistent decline: 85.6% (2013), 86.7% (2014), 83.0% (2015), 80.5% (2016), and 78.1% (2017).
  • A notable decrease in the SER was observed post-clinic implementation.

Conclusions:

  • Home medical care is an effective strategy for supporting homebound patients.
  • Home-visiting clinics can potentially reduce the demand for emergency ambulance services.
  • Implementing home medical care may decrease hospitalization rates for the elderly.