＜Straight Up＞
HEMS in
Japan - Weak Today and Strong Future
The current progress of Japan's helicopter emergency system is running far behind those of advanced countries in Europe and the U.S.
Japan has not fallen behind those countries because we are ignorant of the medical benefits from helicopters emergency medical service. In fact, Japan had conducted experimental helicopter medical emergency service flights in 1981. And in 1994, the Japan Air Rescue Society was organized, whose core members include medical doctors, ambulance crews and commercial helicopter operators. Finally-20 years after the first helicopter medical emergency flights were conducted in 1981-the helicopter medical emergency system known as "Doctor-Helicopter" began service in 2001. After 7 years, 14 Helicopter Medical Emergency Service (HEMS) programs are in operation.
Japan is divided into 47 prefectures, including the metropolitan cities of Tokyo, Osaka and Kyoto. Therefore, about 50 HEMS programs are required in Japan if there is to be one program for each prefecture. Or, 80 programs are needed if Japan maintains the same level of service coverage that Germany has. Through this, we can see that the current 14 HEMS programs now in Japan are less than 30 percent of Japan's minimum requirements, and less than 20 percent of the ideal requirement, such as what Germany has.
It was very fortunate that a special law for promoting the spread of Doctor-Helicopter was legislated by the Diet last summer. It is necessary, however, to improve the current system of subsiding HEMS operations costs for promoting the spread of medical helicopter use. Both central and local governments presently bear half of these operations costs in prefectures that have programs in place, but this system is not sufficient for ongoing healthy operations. The new special law stipulates a way for alleviating the financial burden of local governments by collecting funds from the general public, in addition to social insurances, including health insurance and industrial accident insurance.
Neither funds from insurance nor the reduction of local government financial responsibility have been specifically determined, however, and the law stipulates that these responsibilities should be determined within three years from the date of the law's enactment. From this, we can see that the new law does not really promote expanding HEMS programs in Japan.
The past few years have seen an alarming decline in the number of emergency physicians in Japan, which has led to some hospitals closing their emergency departments, and, in turn, the contributing to the demise of emergency medical systems. HEMS is exactly the indispensable tool and solution to help supplement the shortage of medical care availability in Japan. Social awareness of HEMS has been rising, and the number of local regions that are interested in introducing Doctor-Helicopter has been increasing, which clearly demonstrates an interest and need for HEMS throughout Japan.
Three new HEMS programs, making 17 in total, are expected to start operations by March 31, 2009. In about five years, the number of programs will total 30. And in another five years, we should see 50 HEMS programs in operation. The approximate 4,000 patients currently saved in a year by Doctor-Helicopter will total more than 20,000 per year if there were 50 programs in operation. An estimated 2,000 patients would have already died without the Doctor-Helicopter service to save them-an appreciable number.
Japan should do its best in promoting the spread of HEMS for the good of the general population.
printed in Japan Aviation Weekly of May 26, 2008)
上の英文は、去る５月下旬チェコのプラハで開催された国際航空医療学会 2008 の事前抄録のために書いたもので、山野豊氏に英訳していただいた。それが日本航空新聞社の週刊英字紙にも掲載された。
（西川 渉、2008.6.9）
