The EMS delivery system in Japan is divided into three levels of medical care. One can request the first aid ambulance by dialing the emergency number 119. The ambulance service takes the patient to the first aid clinic (hospital), i.e., emergency department. Physicians and nurses of a city, town or village are being rotated for the first aid clinic once every month or two. A physician has to decide whether or not a certain patient needs further evaluation. When the physician of the first aid clinic (hospital) decides the patient needs hospital admission, he sends the patient to the second aid hospital. When a physician of the second aid hospital judges the patient needs special examinations or surgical treatment which requires the patient's admission to a more advanced facility, he sends the patient to the third aid hospital. At the present time, the third aid hospitals are medical school hospitals and national hospitals.