Clinic-directed ambulance transports within an urban EMS in Japan: one-year descriptive study of 208 cases at a clinic without beds

Abstract Background Emergency medical services (EMS) increasingly manage low-acuity calls alongside time-critical emergencies. Clinic-directed ambulance transports may decompress emergency departments (EDs), yet empirical descriptions from Japan are scarce. Methods We conducted a retrospective descriptive study of all ambulance arrivals to a community clinic without beds in Hiroshima City between July 1, 2024 and June 30, 2025 (n = 208). We summarized demographics, presenting reasons, weekday patterns, and dispositions; age-stratified outcomes and reason-by-disposition patterns were tabulated. Results Median age was 71.5 years (IQR 39.8–83.0); 104 were women and 104 men. Leading reasons were falls (n = 58), syncope/loss of consciousness (n = 22), traffic injury (n = 15), and fever (n = 11). Arrivals peaked on Saturdays (n = 55). Most patients were discharged home (n = 150; 72.1%), 54 (26.0%) required hospital transfer/admission, and 2 (1.0%) had next-day admission. Conclusions Clinic-directed ambulance transports were predominantly low acuity and often completed without hospital admission. With standardized triage and predefined transfer triggers, community clinics without beds may serve as safe first-contact EMS destinations to relieve ED crowding.