Disparity in emergency medical services across Japan

By using a prospective, nation-wide, population-based out-of-hospital cardiac arrest (OHCA) database (All-Japan Utstein Registry, January 1, 2005 to December 31, 2012), we examined the disparity in emergency medical services across Japan and found significant disparities among prefectures. By dividing Japan into seven parts, Hasegawa et al. (2013) analysed regional variability in survival outcomes of OHCA and found a two-fold regional difference in neurologically favourable survival after OHCA. However, seven regions are constructed of North, Northeast, East, Central, Midwest, West, South, and Japan has 47 prefectures. Each prefecture grouped in the same region would be different from others in many aspects. To identify regional disparities more in prehospital care and in-hospital post-resuscitation care, we investigated survival outcomes of OHCA in prefecture levels. As the budgets of central and local governments are not unrestrained but restricted all over the world, the findings in the paper would be beneficial to consider optimal level of regional emergency medical services.