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Analysis of Maternal and Neonatal Transport by the 1339 Emergency Medical Information Center in Busan Area

부산 지역 응급의료정보센터를 통한 산모와 신생아 전원에 대한 연구

  • Kim, Mi-Jin (Department of Pediatrics, College of Medicine, Dong-A University, Busan, Busan 1339 Emergency Medical Information Center) ;
  • Lee, Myung-Chul (Department of Pediatrics, College of Medicine, Dong-A University, Busan, Busan 1339 Emergency Medical Information Center) ;
  • Yoo, Jae-Ho (Department of Pediatrics, College of Medicine, Dong-A University, Busan, Busan 1339 Emergency Medical Information Center) ;
  • Kim, Myo-Jing (Department of Pediatrics, College of Medicine, Dong-A University, Busan, Busan 1339 Emergency Medical Information Center)
  • 김미진 (동아대학교 의과대학 소아과학교실, 부산 1339 응급 의료 정보 센터) ;
  • 이명철 (동아대학교 의과대학 소아과학교실, 부산 1339 응급 의료 정보 센터) ;
  • 유재호 (동아대학교 의과대학 소아과학교실, 부산 1339 응급 의료 정보 센터) ;
  • 김묘징 (동아대학교 의과대학 소아과학교실, 부산 1339 응급 의료 정보 센터)
  • Published : 2011.05.31

Abstract

Purpose: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. Methods: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. Results: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. Conclusion: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.

목적: 산모와 신생아 환자의 응급 진료는 치료의 특수성 때문에 치료할 수 있는 의료 기관 및 자원이 한정적이며, 상황에 따라 유동적으로 변화한다. 이에 저자들은 부산 지역 1339 응급의료 정보 센터를 통해 산모와 신생아 환자의 전원 상태를 조사하고, 주산기 의료 전달 체계의 현황을 파악하고자 하였다. 방법: 2009년 1월 1일부터 2009년 12월 31일까지 부산 지역 1339 응급 의료 정보 센터 전산 시스템에 입력된 자료를 이용하였다. 전원이 의뢰된 산모 378명과 신생아 136명을 대상으로 전원 성공률, 전원 결정까지 접촉한 의료 기관 수 및 소요 시간, 전원 이유, 전원 거절 이유를 후향적으로 조사하였다. 결과: 산모는 전원 성공률이 65.5%였고, 전원 결정까지 접촉한 의료 기관은 2.7개, 소요 시간은 평균 24.4분(11.3-29.8분)이었다. 전원을 의뢰한 이유는 미숙아 분만이 가장 많았고, 전원이 거절된 이유는 의료진 부족, 의료 장비 부족, 병상 부족 순이었다. 신생아는 전원 성공률이 71.3%였고. 전원 결정까지 접촉한 의료 기관은 2.4개, 소요 시간은 평균 15.6분(7.9-21.3분)이었다. 전원을 의뢰한 이유는 호흡기 증상이 가장 많았고, 전원이 거절된 이유는 병상 부족, 의료 장비 부족, 의료진 부족 순이었다. 결론: 응급 의료 정보 센터를 통해 많은 산모와 신생아가 전원되나 전원 성공률은 높지 않았다. 산모와 신생아 환자에 대한 주산기 진료 체계의 적정성 평가와 함께 앞으로 통합적이고 지역화된 주산기 의료 전달 체계의 구축을 위해서는 국가적 차원의 접근이 필요하겠다.

Keywords

References

  1. American Academy of Pediatrics. Guidelines for perinatal care. 6th ed. Elk Grove Village: American Academy of Pediatrics, 2007:66- 81.
  2. Kliegman R. Nelson textbook of pediatrics. 18th ed. Philadelphia: WB Saunders, 2007:380-2.
  3. Shin SM. Development of an online system to access the availability of beds and equipments in the referral centers for the transport of newborn patients. J Korean Soc Neonatol 2001;8:1-9.
  4. Korea Statistic Information Service Population. Statistical database of population household-vital statistics [Internet]. Korea Statistic Information Service Population; 2009 [updated 2009 Nov 1; cited 2010 Mar 14]. Available from: http://kosis.kr/eng/database/ database_001000.jsp?listid=B&subtitle=Population,%20 Household.
  5. Ministry of Health and Welfare. Welfare and family affairs of 2010. Seoul: Ministry of Health and Welfare, 2010:21-3.
  6. Im JS. Developing the model of perinatal center. Seoul: Ministry of Health and Welfare, 2010:1-5.
  7. Thompson LA, Goodman DC, Little GA. Is more neonatal intensive care always better? Insights from a cross-national comparison of reproductive care. Pediatrics 2002;109:1036-43. https://doi.org/10.1542/peds.109.6.1036
  8. Wang ST, Lin CH, Wang JN, Wang CJ, Chen TJ, Yeh TF. A study of the referral patterns of obstetric clinics and the performance of receiving neonatal intensive care units in Taiwan. Public Health 1997;111:149-52. https://doi.org/10.1016/S0033-3506(97)00573-8
  9. Pollack LD. An effective model for reorganization of perinatal services in a metropolitan area: a descriptive analysis and historical perspective. J Perinatol 1996;16:3-8.
  10. Jeon SY, Lee SG. Difference of perception around emergency circumstances between 119 rescuer and utilizer. J Korean Soc Emerg Med 2000;11:212-23.
  11. Park J, Lee J. The study of impediments in the adoption of information systems in public sector: case of the 1339 EMIS. 11th Annual Meeting of the Korean Academic Society of Business Administration; 2009 Aug 18-19; Pyeongchang. Seoul: Korean Academic Society of Business Administration, 2009:1-16.
  12. Jeong JW, Cho SJ, Yeom SR. Requests for Interhospital Transfer Received by An 1339 Emergency Medical Information Center. J Korean Soc Emerg Med 2003;14:544-8.
  13. Mori R, Fujimura M, Shiraishi J, Evans B, Corkett M, Negishi H, et al. Duration of inter-facility neonatal transport and neonatal mortality: systematic review and cohort study. Pediatr Int 2007; 49:452-8. https://doi.org/10.1111/j.1442-200X.2007.02393.x
  14. Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA 2002;288:2151-62. https://doi.org/10.1001/jama.288.17.2151
  15. Bennett CC, Lal MK, Field DJ, Wilkinson AR. Maternal morbidity and pregnancy outcome in a cohort of mothers transferred out of perinatal centres during a national census. BJOG 2002;109:663-6. https://doi.org/10.1111/j.1471-0528.2002.01401.x
  16. Hohlagschwandtner M, Husslein P, Klebermass K, Weninger M, Nardi A, Langer M. Perinatal mortality and morbidity. Comparison between maternal transport, neonatal transport and inpatient antenatal treatment. Arch Gynecol Obstet 2001;265:113-8. https://doi.org/10.1007/s004040100197
  17. Hauspy J, Jacquemyn Y, Van Reempts P, Buytaert P, Van Vliet J. Intrauterine versus postnatal transport of the preterm infant: a shortdistance experience. Early Hum Dev 2001;63:1-7. https://doi.org/10.1016/S0378-3782(00)00128-6
  18. Burguet A, Di Maio M, Besnier-Di Maio S, Kayemba-Kay's S, Nassimi A, Bouthet MF, et al. Very preterm birth less than 33 weeks' gestation: how setting-up of a perinatal network does influence the activity of the neonatal tertiary care unit? The experience of the Poitou-Charentes region, France. J Gynecol Obstet Biol Reprod (Paris) 2007;36:479-85. https://doi.org/10.1016/j.jgyn.2007.02.003
  19. Rettwitz-Volk W. Mortality and morbidity of preterm infants--a synopsis of the german neonatal census 2001. Z Geburtshilfe Neonatol 2003;207:143-7. https://doi.org/10.1055/s-2003-42805
  20. Kempley ST, Sinha AK. Census of neonatal transfers in London and the South East of England. Arch Dis Child Fetal Neonatal Ed 2004; 89:F521-6. https://doi.org/10.1136/adc.2003.029017
  21. Kempley ST, Baki Y, Hayter G, Ratnavel N, Cavazzoni E, Reyes T. Effect of a centralised transfer service on characteristics of interhospital neonatal transfers. Arch Dis Child Fetal Neonatal Ed 2007; 92:F185-8. https://doi.org/10.1136/adc.2006.106047

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