Table 4 Requests (free description) from secondary emergency medical institutions—requests to nearby tertiary medical institutions (3 or more opinions in bold)

141

Patient acceptance requests

Smooth acceptance of patients who have been transferred from one hospital to another, who are seriously ill or difficult to accept, or who have been seen in the hospital before

70

It’s working, thanks

28

Strengthening of cooperation between secondary and tertiary medical institutions

(a system that is easy to contact, easy to consult, easy to request, sharing of information such as medical records and images, and visualization throughout the community)

13

No tertiary care facilities nearby (2 of them are too far away to transport)

13

Yes (unspecified)

10

Strengthening of systems within tertiary care institutions (4 of them: securing vacant beds, expansion of beds), strengthening of cooperation among tertiary care institutions

6

Don’t want them to take all my patients

4

Want overtriage to be allowed

4

Provision of guidance and education by tertiary care institutions

(Guidance through image viewing, collaboration with secondary medical institutions to foster emergency care, and holding and disseminating training)

4

Dispatch of physicians to secondary medical institutions

3

Use downstream transport to secondary institutions to free-up beds for lifesaving and make room for tertiary cases

3

Secondary and tertiary hierarchy unclear (perhaps a future issue)

2

Establish a regional emergency medical care system centered on tertiary medical institutions

(Leadership of secondary medical institutions, designation/allowance of assistant tertiary medical institutions)

2

Education of attitudes and dispositions of staff of tertiary care institutions

1

Nighttime otolaryngology, ophthalmology, orthopedics, and dermatology to be rotated

1

Concentrating mostly on grants and other support for COVID19

1

collaborate with other departments in the hospital

1

Survival of the medical institution

1

Aggregation of emergency physicians and emergency patients

1

Reporting outcomes of referred patients

1

Come and pick patients up