Document Detail


Survival and cost analysis of fatalities of the Kobe earthquake in Japan.
MedLine Citation:
PMID:  15060860     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The authors investigated the dying patterns, and cause and preventability of deaths in a major earthquake disaster, and estimated the cost needed to enhance emergency medical services (EMS) response to prevent "unnecessary" deaths. METHODS: The authors reviewed autopsy data in the Hanshin-Awaji (Kobe) earthquake of 1995. A survival analysis was performed to determine the time course and pattern of dying of these deaths. A cost analysis to estimate acceptable cost for EMS to reduce fatalities was also performed. Potentially salvageable life-years based on expected life-years among fatalities were calculated and used to simulate an acceptable cost for an enhanced EMS disaster response. RESULTS: The authors analyzed 5,411 fatalities. More than 80% of these patients died within three hours. There were statistically significant differences in survival/dying patterns among causes of death. Thirteen percent of victims experienced a protracted death, which could have been prevented with earlier medical or surgical intervention. The monetary cost of these lost lives was estimated at approximately 600 million US dollars. CONCLUSIONS: Survival analysis revealed a significant population of potentially salvageable patients if more timely and appropriate medical intervention had been available immediately after the earthquake. Based on our cost analysis, and assuming a 1% annual probability of an earthquake and a 30% enhanced lifesaving capability of the EMS effort, approximately $ million dollars annually could be a reasonable expenditure to achieve the goal of reducing preventable deaths in disasters.
Authors:
Noriaki Aoki; Akiyoshi Nishimura; Ernesto A Pretto; Katsuhiko Sugimoto; J Robert Beck; Tsuguya Fukui
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  8     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2004 Apr-Jun
Date Detail:
Created Date:  2004-04-02     Completed Date:  2004-07-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  217-22     Citation Subset:  IM    
Affiliation:
School of Health Information Sciences, University of Texas Health Science Center-Houston, Houston, Texas 77030, USA. noriaki.aoki@uth.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Costs and Cost Analysis
Disaster Planning / economics*,  methods
Disasters / economics,  statistics & numerical data*
Emergency Medical Services / economics*,  methods
Humans
Japan / epidemiology
Retrospective Studies
Survival Analysis
Wounds and Injuries / economics,  mortality*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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