Regional variation of pediatric interhospital critical care transport in Japan

Abstract

AbstractBackgroundAn in‐depth understanding of the epidemiology of ill or injured children transported between hospitals is crucial in building regional medical transport services in public health. Although the epidemiological situation varies by nation and region, it has not been well documented in Japan. In this report we described the number of pediatric interhospital transportations and examined the regional variations and trends in the recent decade.MethodsWe performed repeated, cross‐sectional analyses of children (<15 years) undergoing interhospital transportation in 2010, 2013, and 2016–19, using the national database of public ambulances of the Fire and Disaster Management Agency in Japan. We stratified the cases into critical care transport (CCT) or non‐critical care transport (NonCCT) by the illness/injury severity of the transported children. We calculated the national population‐adjusted number of CCTs and described prefectural variations in CCT numbers with analytical thinking.ResultsThere were 23,506 CCTs and 138,347 NonCCTs. The national average of population‐adjusted CCT numbers was 255 per 1,000,000 person‐years. The statistics varied by prefectures, ranging from 25–536 per 1,000,000 person‐years. The annual trends were also diverse across prefectures, increasing in nine, decreasing in six, and static in 31 prefectures. In analytical thinking of regional variations, potential contributing factors included available interhospital transport services and the threshold of direct admission and referral to tertiary‐care hospitals, whereas regional variations were not well associated with geographical patterns or population size.ConclusionsPublic ambulance services were substantially used for CCTs and NonCCTs in Japan. Regional variations should be taken into account for the future policymaking on pediatric interhospital transportation.