Ambulance Use by International Travelers in Japan: A Retrospective Descriptive Study

Introduction: Reports indicate that 22%–64% of travelers experience some illness when in a foreign country. To date, no prior study has reported the use of ambulances by travelers or the epidemiology of travel-related injury. Methods: In this retrospective study, we aimed to describe ambulance use by international travelers, including the rates of travel-related injury and illness. To do so, ambulance dispatch data from January 1, 2010 to December 31, 2018 was used. Results: Overall, of the 43 201 cases of ambulance use during the study period, 524 (1.2%) were international travelers. Ambulance use by international travelers increased from 0.35% in 2010 (15/4311) to 2.54% in 2018 (125/4913), an average annual increase of 0.27%. Of the international travelers, 392 (74.8%) had minor complaints, 110 cases (21.0%) had moderate complaints, 280 (53.4%) had internal disease, and 223 cases (42.6%) had suffered trauma. Regarding location, 253 (48.3%) were from a hotel/lodge, 83 (15.8%) were from a road/parking, and 30 (5.7%) were in the forest/mountain. Conclusion: Most international travelers use ambulances for minor complaints, typically internal disease or trauma, and approximately half access the service from a hotel or lodge.