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YOKOSUKA NAVAL BASE, Japan — The hourlong drive from the Negishi housing area to the Navy hospital in Yokosuka passes several Japanese hospitals.

That drive — especially for critical patients — concerns hospital officials, who have pledged to find a better solution, said U.S. Naval Hospital Yokosuka’s commanding officer, Capt. Charles E. Taylor.

Taylor and his second-in-command, Capt. Greg Hoeksema, are working with the Japanese government to allow American patients at Negishi and its sister installation, Ikego, to go to closer local hospitals, ideally in a Japanese ambulance.

“The bottom line for us is in an emergency situation, the patient needs to get the highest level of care as fast as they can,” Hoeksema said. “Delay is the enemy.”

Taylor took this message to the installations recently during two town hall meetings, where residents expressed concern about language differences and cost and quality of service.

Hospital leaders are fighting what they call misconceptions about the plan, particularly about the level of care patients receive in Japan.

Some residents fear Japanese ambulance staff don’t have the same quality of training as the corpsmen in Navy ambulances.

But that fear is unfounded, officials say. Japanese ambulances have trained emergency medical staff, and because of the volume of calls they receive, they may be more experienced than EMT corpsmen who have fewer emergency calls, Hoeksema said.

In addition to getting patients to facilities faster, Hoeksema said, Japanese ambulances also know the best routes and procedures at local hospitals.

Despite such advantages, naval hospital officials recall several cases when Americans calling for help were adamant about going to Yokosuka, despite the longer drive.

Taylor said doing so puts critical patients at serious risk.

Taylor acknowledged that American hospitals and Japanese hospitals are different, noting that Japanese hospital stays generally are longer and require more tests, but, he said, the priorities are the same: patient health and survivability.

He said hospital officials already strive to get U.S. patients taken to Japanese hospitals — often the outcome in trauma cases — transferred to American facilities as soon as possible.

Residents at the town hall meetings also were concerned about payments, Taylor said, including the Japanese custom of paying up front. Taylor said he hopes an arrangement with the hospitals will allow representatives from Tricare, the military medical insurance network, to work out payments.

Whether at Navy or Japanese facilities, insured patients still will have the same co-pay and deductibles, Taylor said.

Hospital leaders say they understand residents’ language fears and plan to have translators on ambulance trips. The hospital also has Japanese medical interns on hand to help translate.

“It’s an emotionally charged time,” Hoeksema said of trying to work out details of an agreement. But “it’s all about improving quality of care. Sooner or later we’re going to have a bad outcome [due to the time delays] and that’s what we’re concerned about.”


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