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Ambulance diversion has a significant impact on patient care outcomes. Self-harm behavior in particular is associated with difficulty in hospital acceptance. This is a retrospective observational study using the Japanese ambulance dispatch data in 2015. This study aims to determine if high-level emergency care centers and hospitals with both medical/surgical and psychiatric inpatient beds are associated with a decreased rate of difficulty in hospital acceptance and shorter prehospital transfer times for patients seeking medical care after self-harm behavior using 2015 Japanese ambulance dispatch database. Multivariable analyses were performed for difficulty in hospital acceptance and prehospital transfer time. Covariates such as age, gender, the population density, time, and severity, were included in the analysis, in addition to the presence of high-level emergency care centers and hospitals with both medical/surgical and psychiatric inpatient beds in the city. There was an association between decreased difficulty in hospital acceptance and the presence of high-level emergency care centers (Odds ratio 0.62, 95% Confidence Interval 0.55 to 0.70, P |
