{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T22:38:26Z","timestamp":1769121506555,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T00:00:00Z","timestamp":1551312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["H29\u2010Policy\u2010Designated\u2010009"],"award-info":[{"award-number":["H29\u2010Policy\u2010Designated\u2010009"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["H29\u2010ICT\u2010General\u2010004"],"award-info":[{"award-number":["H29\u2010ICT\u2010General\u2010004"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","award":["17H04141"],"award-info":[{"award-number":["17H04141"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Use of a physician\u2010manned prehospital emergency medical service (<jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>) has recently become widespread in Japan. Understanding the epidemiology of critically ill patients is essential for planning national and regional physician\u2010manned prehospital <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> systems. However, current knowledge on patients receiving physician\u2010manned prehospital <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> is sparse. The present study aimed to determine the clinical features of critically ill patients with and without physician\u2010manned prehospital <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>, using a national inpatient database in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Japanese Diagnosis Procedure Combination inpatient database, we identified all hospitalized patients transported to tertiary emergency centers by physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> without a physician from April 2014 to March 2015. We collected data on patient characteristics, in\u2010hospital mortality, admission diagnoses, advanced life support interventions, and incidence of critical illnesses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 497,911 hospitalized patients transported to tertiary emergency centers by <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>. Of these, 15,507 (3%) patients were hospitalized by physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>. The majority of admission diagnoses in the physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> group were classified \u201cdiseases of the circulatory system\u201d (45%) and \u201cinjury, poisoning and certain other consequences of external causes\u201d (34%). The rates of in\u2010hospital mortality, advanced life support interventions, and critical illnesses in the physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> group were 22%, 51%, and 53%, respectively. The median incidences of hospitalized patients by physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>, advanced life support interventions, and critical illnesses were 12, 137, and 205 per 100,000 persons per year in facilities with physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content>, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study indicates that physician\u2010manned <jats:styled-content style=\"fixed-case\">EMS<\/jats:styled-content> is dispatched to a relatively small proportion of critically ill patients in Japan.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.400","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T09:16:35Z","timestamp":1551345395000},"page":"165-172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Physician\u2010manned prehospital emergency care in tertiary emergency centers in Japan"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8544-2569","authenticated-orcid":false,"given":"Hiroyuki","family":"Ohbe","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Isogai","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikio","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taisuke","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Tokyo Medical and Dental University Graduate School of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,28]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Textbook of Trauma Anesthesia and Critical Care","author":"Grande CM","year":"1993"},{"key":"e_1_2_8_3_1","volume-title":"ADACOPTER\u2013Aufzeichnungen Einer Entwicklung M\u00fcnchen","author":"Kugler G","year":"2002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.04.006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.12.019"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2006.04.001"},{"key":"e_1_2_8_7_1","unstructured":"The Fire and Disaster Management Agency of Japan (FDMA).Current status of emergency rescue in 2012 (in Japanese). [cited 28 Oct 2018]. Available from:http:\/\/www.fdma.go.jp\/neuter\/topics\/kyukyukyujo_genkyo\/h24\/01_kyukyu.pdf."},{"key":"e_1_2_8_8_1","unstructured":"The Fire and Disaster Management Agency of Japan (FDMA).Current status of emergency rescue in 2017 (in Japanese). [cited 28 Oct 2018]. Available from:http:\/\/www.fdma.go.jp\/neuter\/topics\/kyukyukyujo_genkyo\/h29\/01_kyukyu.pdf."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.je.2016.09.009"},{"key":"e_1_2_8_10_1","unstructured":"Ministry of Health Labor and Welfare in Japan.The report for functions of medical institutions (in Japanese). [cited 28 Oct 2018]. Available from:https:\/\/www.mhlw.go.jp\/file\/06-Seisakujouhou-10800000-Iseikyoku\/11_h29_byouin_kinyuuyouryou_1.pdf."},{"key":"e_1_2_8_11_1","first-page":"3","article-title":"The eye response test alone is sufficient to predict stroke outcome\u2013reintroduction of Japan Coma Scale: a cohort study","volume":"29","author":"Shigematsu K","year":"2013","journal-title":"BMJ Open"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"e_1_2_8_13_1","volume-title":"ICD\u201010 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines","author":"World Health Organization","year":"1992"},{"key":"e_1_2_8_14_1","first-page":"60","article-title":"Systematization of urgency judgment: from onset to fundamental treatment [in Japanese]","volume":"19","author":"Morimura N","year":"2016","journal-title":"J. Jpn Soc. Emerg. Med."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.DCC.0000325106.28851.89"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199601000-00012"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199903000-00048"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/13.suppl_3.85"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2016-042106"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-18-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12181"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc9319"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-016-0335-z"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00042.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15692-4"}],"container-title":["Acute Medicine &amp; Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fams2.400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ams2.400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/am-pdf\/10.1002%2Fams2.400","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ams2.400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T22:25:12Z","timestamp":1694384712000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ams2.400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,28]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1002\/ams2.400"],"URL":"https:\/\/doi.org\/10.1002\/ams2.400","archive":["Portico"],"relation":{},"ISSN":["2052-8817","2052-8817"],"issn-type":[{"value":"2052-8817","type":"print"},{"value":"2052-8817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,28]]},"assertion":[{"value":"2018-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}