Skip to main content
    • Aa
    • Aa

Resource Utilization in the Emergency Department of a Tertiary Care University-Based Hospital in Tokyo Before and After the 2011 Great East Japan Earthquake and Tsunami

  • Mai Shimada (a1), Aska Tanabe (a1), Masataka Gunshin (a1), Robert H. Riffenburgh (a2) and David A. Tanen (a3)...

The objective of this study was to determine the resource utilization of a tertiary care Japanese emergency department (ED) that was not immediately adjacent to the area of the 2011 Great East Japan earthquake and tsunami.


A retrospective chart review was performed at a tertiary care university-based urban ED located approximately 290 km from the primary site of destruction secondary to an earthquake measuring 9.0 on the Richter Scale and the resulting tsunami. All patients who presented for a period of twelve days before and twelve days after the disaster were included. Data were collected using preformed data collection sheets, and stored in an Excel file. Abstracted data included gender, time in the ED, intravenous fluid administration, blood transfusion, oxygen, laboratories, electrocardiograms (ECGs), radiographs, ultrasound, diagnoses, surgical and medical referrals, and prescriptions written. Ten percent of the charts were reviewed for accuracy, and an error rate reported. Data were analyzed using 2-tailed t-tests, Fisher's exact tests or rank sum tests. Bonferroni correction was used to adjust P values for multiple comparisons.


Charts for 1193 patients were evaluated. The error rate for the abstracted data was 3.2% (95% CI, 2.4%-4.1%). Six hundred fifty-seven patients (53% male) were evaluated in the ED after the earthquake, representing a 23% increase in patient volume. Mean patient time spent in the ED decreased from 61 minutes to 52 minutes (median decrease from 35 minutes to 32 minutes; P = .005). Laboratory utilization decreased from 51% to 43% (P = .006). The percentage of patients receiving prescriptions increased from 48% to 54% (P = .002). There was no change in the number of patients evaluated for surgical complaints, but there was an increase in the number treated for medical or psychiatric complaints.


There was a significant increase in the number of people utilizing the ED in Tokyo after the Great East Japan earthquake and tsunami. Time spent in the ED was decreased along with laboratory utilization, possibly reflecting decreased patient acuity. This information may help in the allocation of national resources when planning for disasters.

ShimadaM, TanabeA, GunshinM, RiffenburghRH, TanenDA. Resource Utilization in the Emergency Department of a Tertiary Care University-Based Hospital in Tokyo Before and After the 2011 Great East Japan Earthquake and Tsunami. Prehosp Disaster Med. 2012;27(6):1-4.

Corresponding author
Correspondence: David A. Tanen, MD Naval Medical Center 34800 Bob Wilson Drive San Diego, CA 92134 USA E-mail
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2. T Okumura , K Suzuki , A Fukuda , et al. The Tokyo subway sarin attack: disaster management, Part 3: National and international responses. Acad Emerg Med. 1998;5(6):625-628.

4. T Okumura , K Suzuki , A Fukuda , et al. The Tokyo subway sarin attack: disaster management, Part 1: Community emergency response. Acad Emerg Med. 1998;5(6):613-617.

5. K Tanaka . The Kobe earthquake: the system response. A disaster report from Japan. Eur J Emerg Med. 1996;3(4):263-269.

6. CL Catlett , JL Jenkins , MG Millin . Role of emergency medical services in disaster response: resource document for the National Association of EMS Physicians position statement. Prehosp Emerg Care. 2011;15(3):420-425.

7. JL Hick , D Hanfling , SV Cantrill . Allocating scarce resources in disasters: emergency department principles. Ann Emerg Med. 2012;59(3):177-187.

9. A Adler . Neuropsychiatric complications in victims of Boston's Coconut Grove disaster. JAMA. 1943;123(17):1098-1101.

11. EH Gilbert , SR Lowenstein , J Koziol-McLain , et al. Chart reviews in emergency medicine research: where are the methods? Ann Emerg Med. 1996;27(3):305-308.

12. S Satomi . The Great East Japan Earthquake: Tohoku University Hospital's efforts and lessons learned. Surg Today. 2011;41(9)9:1171-1181.

13. A Fuse , Y Shuto , F Ando , et al. Medical relief activities conducted by Nippon Medical School in the acute phase of the Great East Japan Earthquake 2011. J Nihon Med Sch. 2011;78(6):397-400.

14. K Seiji . Report immediately after earthquake from a medium-scale hospital in the Sendai City where the emergency outpatient was done [in Japanese]. Sangyo Eiseigaku Zasshi. 2011;53(3):101-104.

15. A Koyama , A Fuse , J Hagiwara , et al. Medical relief activities, medical resourcing, and inpatient evacuation conducted by Nippon Medical School due to the Fukushima Daiichi Nuclear Power Plant accident following the Great East Japan Earthquake 2011. J Nihon Med Sch. 2011;78(6):393-396.

17. K Furukawa , M Ootsuki , M Kodama , H Arai . Exacerbation of dementia after the earthquake and tsunami in Japan. J Neurol. 2012;259(6):1243.

18. JD Bergiannaki , C Psarros , E Varsou , et al. Protracted acute stress reaction following an earthquake. Acta Psychiatr Scand. 2003;107(1):18-24.

M Shimada , A Tanabe , M Gunshin , RH Riffenburgh , DA Tanen . Resource utilization in the emergency department of a tertiary care university-based hospital in Tokyo before and after the 2011 Great East Japan Earthquake and tsunami. Prehosp Disaster Med. 2012;27(6):1-4

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 2
Total number of PDF views: 5 *
Loading metrics...

Abstract views

Total abstract views: 129 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th September 2017. This data will be updated every 24 hours.