Cancellation case analysis of physician-staffed rapid response car activities during off-hours in the central region of Saitama prefecture, Japan: a retrospective study.

内容摘要

Among hospitals in the central Saitama Prefecture, only the Saitama Red Cross Hospital (SRCH) provides physician-staffed rapid response car (RRC) services during off-hours (weekday night-time, weekends, and public holidays). During off-hours, concentrated dispatch requests increase the operational and financial burden, particularly when cancellations occur. Furthermore, research on RRC cancellation in the Japanese urban emergency medical system remains limited. By examining the epidemiological characteristics of RRC cancellation, this study aimed to optimise RRC operations and enhance emergency medical response efficiency. This retrospective study analysed RRC dispatches from SRCH between January 1, 2021, and December 31, 2023, focusing on cases classified as 'cancelled' or 'treated'. Variables including age, disease type, distance from the hospital, request source, and time of request were compared using chi-square test, t-test, and Mann-Whitney U test. Logistic regression was performed to identify independent predictors of cancellation. Of 4,005 dispatches, 1,091 were cancelled, and 2,417 were treated; 497 cases were excluded because of incomplete data. Cancellations were significantly associated with patients aged ≥ 65 years, requests initiated by the Command Centre, and greater distance from the hospital. Respiratory failure and anaphylactic shock had the highest cancellation rates. Improving dispatch strategies can enhance pre-hospital emergency care, ensuring timely medical attention for critical patients, while reducing operational and financial strain on medical institutions.