The pattern of ambulance arrivals in the emergency department of an acute care hospital in Singapore.

OBJECTIVES: (1) To determine the pattern of ambulance arrivals in the emergency department (ED) and (2) to review resource allocation based on these data. METHODS: All (13 697) ambulance arrivals in 1996 to the ED of Tan Tock Seng Hospital were studied and where relevant compared with the walk in and total arrivals of the same year. The following data were obtained from computer records: (a) patients' demographic data; (b) number of ambulance arrivals by hour; (c) the classification of the ambulance arrivals by emergency or non-emergency, trauma or non-trauma; (d) cause of injury for trauma cases; (e) discharge status. RESULTS: The ambulance arrivals in 1996 constituted 12.4% of the patient load for this department. There was no difference in modes of patient arrival to the ED by sex and ethnic group. However, there was significant evidence to show that more patients age > 60 came by ambulance than those age < 12 (p << 0.01). Some 98.5% of the ambulance arrivals were emergencies; 40.7% of the ambulance arrivals were attributable to trauma versus 27.3% of the walk in arrivals. The majority of the trauma cases brought in by ambulance were because of road traffic accidents (15.3%) or home accidents (7.4%). The peak in ambulance arrivals was between 2100-2300 hours compared with 1000-1200 for the walk in arrivals. More than half of the ambulance arrivals were admitted. CONCLUSION: In planning resource allocation and in the development of contingency plans, the resource use of ambulance patients and the pattern of their arrivals should be taken into account.

The impact of the anti-smoking campaign in Singapore.

PIP: The Singapore National Smoking Control Programme was launched by the government's National Smoking Control Coordinating Committee in September 1986, under the Ministry of Health. Its theme is titled "Towards a Nation of Non-Smokers." The objectives are to prevent youths from starting to smoke by health education and smoking cessation services, to protect the rights of non-smokers and to tighten existing smoking regulations and increase excise taxes. The program began in December 1986 with a 3-month intensive media campaign and a smoke-free week. A national survey on smoking in July 1987 including 78,600 persons showed that smoking had declined 26% since a comparable survey in 1984. Smoking prevalence had fallen from 5.1% to 2.9% of youths, and form 24.6% to 17.4% of adults aged 45-49 years. Smoking is more prevalent among Malays than Chinese, and among male unemployed, production, transport and labor workers. It is lowest in secondary school educated women. Singapore's 1987 prevalence ranks 11th among 11 countries whose smoking prevalence was published by WHO in 1985.^ieng