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© KYODORecord high number of ambulances struggling to find hospitals in Japan
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Josu
What kind of profile is that of the deceased?.
Unvaccinated?
Old people?
Patients of other patologies?
Terrible news for all but, just wanted to know more about it.
If anyone knows, please share.
sakurasuki
Even before Covid strike, hospital in Japan rejects people that in need emergency.
https://www.straitstimes.com/asia/japan-man-dies-after-hospitals-reject-him-36-times
Antiquesaving
Perhaps it is time for the Japanese Fire/ambulance/medical system to at least upgrade to the 20th century and have the central dispatch decided where to take patient.
Way back in the 1980s when the central 911 because widely used in North America, the dispatch not only took the call picked the nearest ambulance but also informed both the ambulance where it could go and TOLD the hospital it WILL be receiving an ambulance.
Hospitals were not given a choice.
A Doctor or Nurse at the dispatch centre makes the decision based on patients condition relayed by the paramedics.
The hospital cannot say no
Kev James
Imagine paying all your taxes and health insurance and then getting injured or seriously sick during OBON when a lot of hospitals are closed. I mean, it’s a hospital - how on earth could they be closed?? It’s a frightening thought I may need an ambulance one day and be stuck in the back for hours as they ring dozens of hospitals looking for a bed.
theFu
The title and first paragraph make it seem like they are lost and don't have GPS with navigation.
Rationed health care has many good things about it, but overabundance is not one.
obladi
As an American living in Japan, one of the biggest culture shocks was the difference in response to emergencies. In the US, Rambo as shows up, takes control of the situation, you are stabulized and whisked away through parting cars like Moses. In Japan, it's a couple of guys, not particularly in a hurry, who show up and then proceed to call various hospitals on the phone. After they find a hospital to take you (if they can), they drive slowly through traffic that doesn't really get out of the way.
My attitude has been to just try not to get hurt in Japan...
dagon
Expressions of gratitude from the PM and flyovers by the SDF were not enough?
Instead of devoting resources to essential care workers who are grossly overworked and underpaid dining and hotel chains have been bailed out and kept afloat by the LDP pandemic response?
The LDP has been grossly negligent.
David Brent
Such a third world system here.
Imagine an ambulance being turned away from a hospital back in the west.
Steven Mccarthy
With 1.8 million people in hospitals, hotels, or other facilities under the care of Drs and nurses around the clock…. It’s a multitude of problems…. There’s no where to send anymore patients …. The healthcare system has completely collapsed…. Healthcare workers catch Covid too…. And they’re already stretched too thin …. Some patients are dying at home….. I see another flu reference here …. Covid is not the flu … not the same as the flu …. Nothing even remotely close to the flu …. The fix to the broken system is quite easy…. But every person, clinic , hospital are under the National healthcare system… the National govt needs to remind these hospitals that refuse Covid patients that they’d be broke …. Bankrupt without the National health insurance system….. the current situation is only going to get a lot worse before it gets better …
Yubaru
True, but not at the level seen today. Only specific hospitals are charged with taking in COVID patients and when the ambulance picks up a patient with respiratory problems, it is automatically assumed they are more than likely positive for COVID, hence the limited options of where to take the patient.
Hospitals down here are at 100% or near, give and take a couple of beds, for COVID patients, and until the government reclassifies COVID, there will continue to be stories like this, and worse, in the news.
Because of Japanese health laws regarding communicable illness, only specified hospitals are capable of handling quarantine patients.
My wife went into the hospital yesterday for a reoccuring problem she has had over the past few years and may need surgery. It took nearly 10 hours to get admitted, all along having serious abdominal pain. And there was nothing I nor anyone could do about it. Fortunately we took her, and didnt need an ambulance!
Both of us had to have COVID tests before we were allowed into see the doctor, and that took literally 5 hours to get results.
This is a deadly serious situation.
Yubaru
Quite so, but if you stick around JT long enough you really get good at reading between the lines and understanding what they mean in the first place. Many times things get literally lost in translation.
It' not really "rationed" health care, it's just an over abundance of small hospitals and specialized hospitals that are not equipped to deal with medical emergencies.
I would call it "designated" health care. Each prefecture only has a certain number of hospitals that are specifically designated as "emergency" hospitals. Also many of the large "sogo" hospitals will not take patients off the streets. One needs to have been referred to them from a local clinic or another hospital. Even when does manage to get into one, it literally can take an entire day to be seen.
The system is set up as kind of like a "triage" system where the smaller local clinics and hospitals funnel the more serious patients to the larger one's.
There quite literally is an "overabundance" of small clinics and hospitals here. Within a 10 minute drive from my house, I can get to at least 30 different clinics, smaller hospitals, and at least 5 large, and 2 sogo hospitals and the prefectural University Hospital, and 2 emergency centers. There are literally well over 100 hospitals and probably double that for clinics in Okinawa alone. A population of 1.4 million people.
Dont get me started on dental clinics!
PTownsend
My anecdotal response: last week my wife had an emergency medical situation, severe cancer treatment side effects, an ambulance was called, minutes later EMTS arrived and attended to her, before shifting her to the ambulance, then with sirens and horns blaring (while one EMT used the external speaker to apologize to other drivers and pedestrians) she was whisked to an emergency room where she was attended to by respectful, competent healthcare staff, and successfully treated.
This experience led me to have respect for the emergency care system, at least here in Kobe. This was the second time we had dealt with EMTs and emergency rooms, both successfully. In our experiences we have found that the government hospitals seem to have higher levels of healthcare and more respect for patients than some private hospitals.
virusrex
That does nothing to solve the problem nor refutes the arguments.
For the problem of ambulances not finding an option to hospitalize patients during an emergency the suspicion of covid is enough. If you think emergencies can hold until a PCR test is done to eliminate the possibility of infection (to a realistic level) you simply don't understand what an emergency is.
noriahojanen
Exactly. Due to outdated regulations, many ordinary clinics and their beds remain unused no matter how much they are ready and willing to accept corona outpatients. By contrast health centres are always paralyzed due to compulsory case reporting. The current regime makes everyone, both frontline workers and patients (regardless of corona or not) unhappy, stressed and sick. Note that quite many have died of other reasons than covid.
Yubaru
You and everyone else who doesnt know, need to understand the laws regarding ambulances here when they are on the road. (I have driven an ambulance here for a number of years, when I worked for a hospital system here)
Ambulance drivers are not allowed to go over the speed limit. Reread that please and let it sink in.
Ambulances are, by law, to be given the right of way, and people who do not give the right of way, can be ticketed. Ambulances are authorized to go through red lights, after thoroughly checking traffic.
Phil
Yubaru Today 07:50 am JST
This is a silly example, but this is what the ambulance crews are up against everyday and then you add Covid into the mix and there job to find a hospital can be a nightmare.
Mark
Instead of spending Trillions of Yens on defense how about spending it on COVID Offense!?
Antiquesaving
No it won't!
90% of my dealings with the Ambulance service here were before Covid, my son had a chronic illnesses that required multiple surgeries and he was rushed multiple times to the hospital from school and home.
Each time spending more time sitting infront of the school or house trying to find a hospital than the drive took.
The same thing repeated as my late wife battled cancer.
It go so frustrating that on a few occasions I removed them from the ambulance either got my car or took a taxi to the hospital with them lying across the backseat.
Covid is just the latest excuse.
Dave Fair
This problem of not ambulances but citizens in need of immediate medical attention being REJECTED by public and private medical institutions in Japan is nothing new and could EASILY be remedied. Problem is the Liberal Democratic Party (LDP) and the Health and Welfare Ministry are unwilling to put the people over political donations and cozy retirement jobs from the medical institutions.
I told my wife that it's a waste of time to call 119 for an ambulance here in Japan as we would bleed to death before we eventually get to a hospital and instead get her or myself into the car and drive the 10 minutes to the ER. Lets see them refuse us at the emergency room doors! I actually had to do this 28 years ago in the United States when I woke up in the middle of the night as my girlfriend at the time was burning up in a pool of sweat, and unresponsive. I picked her up, loaded her into the car and rushed her to an ER, 10 minutes away saving precious time. Unfortunately more lives will be lost in Japan and nothing is going to change in the foreseeable future.
BigP
How many times has the government promised that this situation will never happen again?
And here it is again! They are just a pack of lying old men. Put them in an ambulance and have them driven around for hours looking for a hospital. I have paid my hard earned money for this ridiculously poor service
rcch
*that’s some 4th(!) world country s** …
smh
Nihon Tora
Why on earth don't they do LFTs here? In other countries, they were all over the place - anybody at any time if they suspected they might have been a close contact or had any symptoms could do a quick LFT to check and have a result in 5 minutes. I know they are not the most accurate, but for the vast majority of cases or situations like the above, they would be quite adequate. It would have also saved a lot of stress on doctors and hospitals having to test hordes of people with mild symptoms. The Japanese government seriously dropped the ball there.
Right now, the virus should be re-classified at a lower level so that more facilities can accept COVID patients - just like I've been saying on here for MONTHS, only to receive a load of downvotes in response.
Mohan
Welcome to Society 5.0
Seigi
Sensational journalism will just want to connect this to Covid when in fact this has always been the case during influenza season as well as at the peak of summer when heat stroke strikes!
canigetawhatwhat
Maybe people need to stop using them as taxicabs for a runny nose.
Tom San
I wouldn't come down too hard on ambulances in Japan.
Has anyone ever seen how bad the situation in Manila is with regards to ambulances getting stuck in traffic?
Japan is way better.
Makoto Shimizu
The truth is that Japan health system still is not prepared to tackle with large emergency situations as this covid-19 pandemia. Perhaps should look at China's response to covid-19, lockdown, express building of hospital facilities. The main problem was the relaxation of preventive measures, people and companies are exhausted of the mask and social isolation but the only way to reduce infection depends on everyone to self-control themselves.
Yubaru
Actually good luck with this one, but there is an easier solution of you know the system here. All you would need is an orthopedic doctor, of which they are a plethora of here in Japan. Podiatry is not a huge specialty here in Japan.
smithinjapan
The quality of medical service in Japan is quite high... the problem is that care providers can pick and choose when to give it, while still getting funding from government to provide care to ALL.
Dave Fair
The ambulance service is not the issue at all as they are doing the best they can under the circumstances they did not create. They must be so frustrated with the system and are surely the ones with the answers on how to correct the situation as they live it on a daily basis.
Rodney
It takes up to three hours to clean an ambulance for the next patient.
finally rich
to be fair, the only time I needed one (motorcycle accident) they were quite fast, still not sure if I was drowsy or sth but I believe they showed up between 1-2 minutes after the accident, maybe I was just "lucky".
All went smooth, problem was as it was a traffic accident they said I cant use my health insurance (kokumin) so I had to pay ¥60.000 for a few x-rays and band-aids. Was promptly reimbursed by the driver's insurance company later, still I guess not many foreigners walk around with 6man in the wallet or have a credit card as backup
fraris
May it be because ambulances belong to the fire department and not to the hospitals? If ambulances belonged to hospitals as happens in most countries they wouldn't have problems getting back to the "home" hospital instead of wandering around.
Antiquesaving
Seriously?
Why do people think everything in the west is the USA.
Most developed countries Ambulances are free, Japan isn't special, where Japan is different is In most other developed countries the central dispatch decides the hospital and there is no such thing as a hospital refusing except in very rare occasions.
I speak as a former paramedic where over 30 years ago in my country I never once was refused and the dispatch took care of everything even before we were ready to get on our way.
Not once in all the years my son was in need of medical attention, not once when my late wife needed an ambulance did it go smoothly.
Each and every time it was sitting in the ambulance while they tried finding a hospital this included being rejected by the emergency room of the regular hospital both were being treated at.
On one occasion my late wife collapsed when out, the ambulance took a long time to find a hospital and dropped her at a tiny hospital not equipped to care for her.
I picked her up drove her to the university hospital she was being treated for cancer at
They could not refuse her at that point, but when her treating doctor found out the ER had refused her he exploded.
He gave the ER staff an earful then they just turned around and told him it was none of his business how they run the ER.
They don't care as long as they are not busy in the ER.
Japan has a very good medical system with the exception of emergency services
Andy
Ambulances in Japan have their sirens and loud speakers blaring as they drive at a snail's pace. People could die in the back of an ambulance waiting to crawl through a set of traffic lights.
Rakuraku
Spot on.
Antiquesaving
Again what is this "most countries " as far as I know, Only the USA do ambulances belong to hospitals,
France, UK , Germany, Canada, etc...in most cases they are government run, either national/state/province or city.
As a paramedic over 30 years ago in Canada our ambulance service was provincially run.
SarcasmOnly
Yubaru - appreciating the insightful comments from your past experiences and work. Big thank you for having done a crucial job for all of us (driving an ambulance) by the way.
((not sarcasm))
wallace
Dreadful stories in the UK. Read one about a 95-year woman collapsing on the street. An ambulance was called via the emergency services but it took 11 hours to arrive. Other stories of patients being left for hours in hospital corridors.
Eastman
system seems very outdated to me?
btw many of dead are vaccinated people/just JT never mention that in their daily "reports" as people have to be mentally ready for fourth shot this autumn?/... no one need to think why...
finally rich
erh, ok..... maybe you should look at this very fresh piece of news (yesterday) showing terrified shoppers rushing for the exits as security guards do their best to trap them inside Ikea in Shanghai going into sudden lockdown
wallace
I live very near to our municipal hospital. Ambulances go there all day long.
Alex
Nepalibabu, I agree completely with your comment, though I would add (somewhat unrelated to this news story) that not everything about the healthcare system here works "beautifully". Another example of something that doesn't work so well is that those using the NHI tend to be pushed out of the physician's office as quickly as possible - as though we deserve less quality care for being on the NHI. Especially for first-time visits, time is surely required for the doctor to run the necessary tests and make the correct diagnosis.
However, in my experience for a variety of issues, the doctors want you in and out, and so they do what they can in five minutes (despite your lengthy waiting time) and then decide your diagnosis based on that. ...Far often than I can count, mis-diagnosing. (The first time I ever got the flu, I had to go to three separate doctors here before I finally got the correct diagnosis. The first insisted I was just experiencing allergies and made me purchase an inhaler that made my symptoms worse, the second said that I had a bacterial infection, and finally, when the medicine I had paid for did nothing but make me worse and worse, the third doctor diagnosed me correctly with the flu.) Of course this isn't the case everywhere, but it's been my experience for a variety of health issues. I think the doctors need to take more time to be sure they give the patients a correct diagnosis.
Alex
(And I'll add, America's healthcare system - the cost - is a nightmare and utter crap. But not once when I lived there did I ever experience doctors rushing to get you out of their office. Doctors took the time necessary to do their jobs and correctly diagnose you. It's something I've missed here.)
wallace
In the UK, the "999" (The world's oldest emergency services phone number) emergency services are government-run. It is overseen by Ofcom. The operators are trained staff. I have a cousin who is a qualified nurse who works for the service. They can access the condition of the injured person and give medical advice. They can inform the ambulance of what is happening at the scene.
garypen
What I don't understand is that hospitals here are required to take ER patients who go there via private transportation, but can refuse patients who arrive by ambulance? That's utterly ridiculous.
Why doesn't the law requiring them to take the first group also apply to ambulances? Insanity!
Antiquesaving
And?
What does that have to do with the fact hospitals reject ambulances.
As a paramedic in Canada a hospital could receive 3 even 4 Ambulances at the same time and that is why ERs have multiple teams.
So the hospital near you get ambulances it doesn't mean they aren't reject others.
Not to mention inter hospital transport.
My late wife was regularly transported from one hospital to another for a particular treatment then returned the same day each time coming and going through the ER bay.
The article is clearly pointing out a fact, not a perception.
Monty
And as an information for the people who still think that it is impossible to get a Corona Test in Tokyo:
I am on my way to work now and changed trains in Shinagawa.
I just past by another test station.
They have about 8 test boxes where you can get tested fast and easy.
And it doesn't look overrunned by people.
But you have to fill out a kind of information or application form, but that's it.
Fill out the form, get tested, finish!
So again, don't always believe what you read here and get told here.
Because it is 90% sensational, fearmongering, panic sheering nonsense!
Better open your eyes and see the reality with your own eyes.
And always read the articles clearly and especially try to understand what is written in the article you are reading.
Is believe, do NOT mean, that it automatically is.
Have a nice day everyone! Arrived at work.
wallace
Antiquesaving
wallace
Not all hospitals refuse ER ambulances. While it is a problem, especially during the night, and needs a solution.
Two days ago, you posted you had given up on your country Canada 20 years ago.
I have had only one medical emergency during the night in 30 years and on that occasion, it worked out for me to have an operation.
A lot as to do where you live.
The post is about Tokyo.
@PTownsend 07:57 am Kobe.
Moderator
Readers, please keep the discussion focused on Japan.
Brian William Meissner
Thank you for publishing this article, this is not a new issue and it’s a disturbing one for public safety and well being. Ones profile does not matter when it comes to needing energy services heck we just heard about the guy on the motorcycle the other day.
Brian William Meissner
I’ll say it again Japan needs makeshift wards. The medical industry here cannot expect to beat this virus here without adapting the medical info structure
Brian William Meissner
Btw not energy services emergency services
wallace
The many doctors I know during the pandemic had to work longer hours to the point of exhaustion. The nurses I know have said the same and a few have changed their jobs.
Some hospitals are better than others at receiving emergency patients who have tested positive for covid. Understandably, people with positive covid tests can not be allowed into a part of the hospital where there are other patients. But nonetheless, they still need emergency treatment, even life, and death.
The pandemic has exposed the lack of public hospitals. There are about 8,000 hospitals but I believe only 800 are public ones.
There needed to be a system in every city for treating emergencies with patients who have covid or tested positive. but without exposing other patients.
Brian William Meissner
Btw just to be clear hospital services are great once in the hospital but the issue here is acceptance of people in emergency situations
Randy Johnson
Btw just to be clear hospital services are great once in the hospital but the issue here is acceptance of people in emergency situations.
It really depends on the hospital.
Thagoon Kartop Rujirapong
In many countries, temporary hospitals are established. While there are many patients Differentiate the severity of symptoms for treatment. If the Japanese government can't do it, they should look at other countries as an example.
Antiquesaving
Did you read the article?
It doesn't matter what hospital you like or want, if you are in the ambulance and the hospital says no to that ambulance then they will not go there.
If you go on your own no ambulance then any emergency room must accept you they cannot physically remove you.
Antiquesaving
Now we have a clear problem in Tokyo and Japan as a whole, this is a record but not something new only worse since covid.
So we get the "I must defend Japan" crowd that scours the internet for the rare one or 2 cases from the UK a few anecdotes and attempts to divert attention from Germany and the USA.
Even those that try and lessen the severity of their own experience.
The simple fact is Japan doesn't have a central coordination for dispatching Ambulances TO hospitals, leaving finding a hospital up to the ambulance crew.
As a former paramedic, this is insane, so as a person is in cardiac arrest as the paramedic team is performing CPR, one member sits there calling one hospital after another trying to get one to accept the patient.
Think about that!
Don't come back with some odd story from another country, the problem is here, the problem is in the article and several more over the decades alway the same long before Covid.
The scenario above I give is not a maybe, it is not a rare case it is how every call is done, it may be a cardiac arrest, a broken leg ( like yesterday's article) it could be a work accident, or heatstroke.
In all cases the ambulance personnel needs to wait as they try and find a hospital.
There is no defending a broken system especially by pulling out a few rare cases of mistakes from another country.
Antiquesaving
Well I wish it was that simple.
The reason other countries use central coordination is because at certain times a certain hospital can be overwhelmed.
The central control can evaluate how many Ambulances each hospital has received in X amount of time and the severity of each case.
If the hospital ER is presently treating several cardiac patients and has no space for another then, there is no point sending any more their way, so the dispatch will divert to the next nearest with the needed facilities.
Example: transporting a sever burn victim, no point to transport to the mid size hospital without a dedicated burn unit, so dispatch would send us to a hospital with burn ward, if the nearest one by chance is already dealing with previous burn victims in the ER then the dispatch knows this and despite it being slightly farther, we transport to a hospital that has a burn unit and can take the patient right away.
This is how a proper system works and how it works 30 years ago when I was a paramedic back home.
Brian William Meissner
@yubaru
i appreciate your prospective as an ambulance driver here in Japan but you need to realize us as foreigners are comparing it to our system. This isn’t a law issue, it’s more of an infrastructure issue, in the US there is literally enough room for cars on the left lane and right lane to go to the side of the road and allow the ambulance to high tail it down the center of the road. Meanwhile it’s a cluttered mess here in Japan when it comes to ambulances.
finally rich
Can someone please elaborate on why ambulances in Japan have their sirens blaring regardless if its a major road or residential areas say by 2, 3am when the roads are mostly empty? And why those emergency blood SUVs are at least 5x louder, to point of making everything around to vibrate?
Antiquesaving
I don't know if this is fact.
Once when my son was being transported to hospital by ambulance, it was very late I asked not to use the siren until we hit the main road so as to not get every neighbour up and staring at us out their window.
I was told that for liability reasons as long as they are moving with a patient they are required to use the siren.
Is this true, I don't know but the paramedic said this.
sf2k
It's so weird that dispatch and hospitals are separate! Even the USA can do it
Yubaru
Bull, they do not have to use their sirens, and it is quite common on quiet back streets for ALL ambulances to shut off their sirens for the very reasons you stated. I personally live on a "quiet" road, and when ambulance come down during the night, their lights alone are enough to warn people of their coming.
When they get out on the national highway, then they flip the switch.
I would have reached over and shut it off myself, well that's probably because I know where the switch is!
Yubaru
This is BS too! You could fall over at the entrance of a university hospital and they will call for an ambulance to take you to another facility!
And remember too, NOT all hospitals have emergency services in Japan!
Fra poke
And think that Japan has one of the highest ratios of beds to 100k inhabitants in the world. The Japanese health care system works perfectly in normal times but since its pillars sit mostly on private clinics it doesn’t work at all in an emergency situation. Private = profit so this country needs to seriously rethink its health care system asap
vendingmachinemusic
Tinder technology should be utilized by hospitals and ambulances.
swipe for a match
garypen
THAT is the problem.
JTC
A couple of years ago, I had been stuck in a situation like this, lying in an Ambulance, waiting whilst they call around finding a Hospital that'd accept a non-Japanese Speaker. It doesn't happen all the time, in dire emergencies they do go to the nearest available hospital.
painkiller
Record high number of ambulances struggling to find hospitals in Japan
It's not like the ambulances had an easy time finding hospitals before the Covid crisis.
And often the firefighters or whoever are in the ambulance don't/can't administer any medical treatment and so they are a loud, bumpy bright ride.
kaimycahl
Just as I posted many times this virus is not going anywhere, the number will continue to climb. You can not kill a virus so we might as well get use to this.
kaimycahl
Some one is fudging the numbers if ambulances can't find hospitals that means the reporting is inaccurate in terms of the covid numbers being reported
Yubaru
Wow, I really do not follow the logic here. Just because the person being transported shows potential symptoms of COVID does not mean they actually have it, but out of precaution the hospitals that can take them are limited.
And another thing, not all COVID patients are transported by ambulance, in fact their number is a tiny, if not miniscule number, just based on the total overall numbers. I highly doubt that 20,000 plus "positive" results for Tokyo alone were all people taken to hospitals by ambulance.
wanderlust
I remember being told of my own admission to a hospital here for a medical emergency a few years ago; the ambulance came quickly enough when it heard the important words heart and unconscious, and the crew loaded me in the back, but then spent 15 minutes managing paperwork and making calls before it took off slowly down the road. Could not fault the local hospital though, they rushed me in, revived me and I spent the next 2 weeks in coronary care.