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BMJ Open. 2019 Feb 9;9(2):e023836. doi: 10.1136/bmjopen-2018-023836.

Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study.

Author information

1
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Kyoto, Japan.
2
Department of Internal Medicine, Kawauchi Village National Health Insurance Clinic, Futaba-gun, Fukushima, Japan.
3
Department of Internal Medicine, Hirata Central Hospital, Ishikawa-gun, Fukushima, Japan.
4
Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan.
5
Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan.
6
Research Center for Community Health, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.
7
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
8
Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
9
Teikyo University Graduate School of Public Health, Tokyo, Japan.
10
Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan.
11
Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.
12
Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan.

Abstract

OBJECTIVES:

Sustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster.

DESIGN:

This research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality.

SETTING:

The residents in Kawauchi Village, Fukushima, Japan were forced to evacuate after the 2011 Fukushima disaster. As the radiation dose was an acceptable level, the residents began the process of repopulation in April 2012.

PARTICIPANTS:

This study included patients transported by EMS from January 2009 to October 2015. Patients transported during the evacuation period (from March 2011 to March 2012) were excluded.

RESULTS:

A total of 781 patients were transferred by EMS (281 patients before the disaster, 416 after repopulation and 84 during the evacuation period). A Bayesian time series analysis revealed an increase in total EMS time, from the first request call to arrival at a hospital of 21.85 min (95% credible interval 14.2-29.0, Bayesian one-sided tail-area probability p=0.001). After the disaster, 42.3% of patients were transported to a partner hospital.

CONCLUSIONS:

Total EMS time increased after repopulation of the area affected because of a massive number of hospital closures. Proactive partnerships would be a possible countermeasure in the affected areas after a major disaster.

KEYWORDS:

public health

PMID:
30739080
DOI:
10.1136/bmjopen-2018-023836
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Conflict of interest statement

Competing interests: None declared.

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