A Home-Visiting Clinic Decreased the Emergency Transportation in Rural Japan: A Quasi-Experimental Approach.

Abstract

This study examined whether a home-visiting clinic decreased emergency transportations in the region, using a quasi-experimental approach derived from private practice. This study employed a retrospective observational design and was conducted in suburban Tome City, Miyagi Prefecture, with a population of approximately 80,000 and an aging population rate of 35.5% in 2020. Information on ambulance services and the age distribution in Tome City was obtained as confidential data from Tome City. Data on ambulance services and age distribution across Japan was obtained from a publicly accessible dataset. We calculated the standardized emergency transportations due to sudden illness ratio (SER), based on the standardized mortality ratio. This ratio represents the relative incidence of emergency transportations due to sudden illnesses in Tome City compared to all of Japan (with 100 for Japan), adjusted for the age distribution in Tome City through an indirect method. The SER increased to 88.2% in 2011, remained high at 89.6% in 2012, and declined from 85.6% in 2013, the year the home-visit clinic was established, to 86.7%, 83.0%, 80.5%, and 78.1%. The findings suggest that home medical care is an effective means of providing medical assistance to homebound patients and may reduce the necessity for hospitalization and ambulance services.