Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
권호 표지

Primary visit, transfer, and re-transfer to emergency department in patients with severe emergency diseases in Chungnam

충남에서 발생한 중증응급환자의 응급의료기관 일차 방문, 전원 및 재전원 현황

  • Choi, Il Kug (Department of Emergency Medicine, Dankook University College of Medicine) ;
  • Choi, Han Joo (Department of Emergency Medicine, Dankook University College of Medicine) ;
  • Lee, Hae Jung (Chungnam Emergency Medical Service Support Center, National Medical Center)
  • 최일국 (단국대학교 의과대학 응급의학교실) ;
  • 최한주 (단국대학교 의과대학 응급의학교실) ;
  • 이혜정 (국립중앙의료원 충남응급의료지원센터)
  • Received : 2018.04.24
  • Accepted : 2018.08.20
  • Published : 2018.10.31

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Abstract

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

Keywords

References

  1. Institute of Medicine Committee on the Future of Emergency Care in the U.S. Health System. The future of emergency care in the United States health system. Ann Emerg Med 2006;48:115-20.
  2. Carr B, Martinez R. Executive summary: 2010 consensus conference. Acad Emerg Med 2010;17:1269-73. https://doi.org/10.1111/j.1553-2712.2010.00941.x
  3. Gordon HS, Rosenthal GE. Impact of interhospital transfers on outcomes in an academic medical center. Implications for profiling hospital quality. Med Care 1996;34:295-309. https://doi.org/10.1097/00005650-199604000-00002
  4. Nathens AB, Maier RV, Brundage SI, Jurkovich GJ, Grossman DC. The effect of interfacility transfer on outcome in an urban trauma system. J Trauma 2003;55:444-9. https://doi.org/10.1097/01.TA.0000047809.64699.59
  5. Karipis H, Scheinkestel CD, Tuxen DV, Cooper DJ. Safety of transportation of critically ill patients. Anaesth Intensive Care 1993;21:A7111.
  6. Bristow PJ, Brown D, Lee A, Buist MD. Transfer of severely ill patients. Anaesth Intensive Care 1995;23:A399.
  7. Durairaj L, Will JG, Torner JC, Doebbeling BN. Prognostic factors for mortality following interhospital transfers to the medical intensive care unit of a tertiary referral center. Crit Care Med 2003;31:1981-6. https://doi.org/10.1097/01.CCM.0000069730.02769.16
  8. Cho SJ, Hwang SY, Lee JH, et al. Survey of emergencyrelated physicians on inter-hospital transfers via 1339 in Busan. J Korean Soc Emerg Med 2013;24:131-41.
  9. Ahn KO, Hong JY, Kim Y, Jung KY. Appropriate interhospital transfer of emergent patients. J Korean Soc Emerg Med 2006;17:138-45.
  10. Feazel L, Schlichting AB, Bell GR, et al. Achieving regionalization through rural interhospital transfer. Am J Emerg Med 2015;33:1288-96. https://doi.org/10.1016/j.ajem.2015.05.032
  11. Cha WC, Shin SD, Song KJ, Jung SK, Suh GJ. Effect of an independent-capacity protocol on overcrowding in an urban emergency department. Acad Emerg Med 2009;16:1277-83. https://doi.org/10.1111/j.1553-2712.2009.00526.x
  12. National Emergency Medical Center [Internet]. Seoul: National Emergency Medical Center; 2018 [cited 2018 Aug 9]. Available from: http://www.e-gen.or.kr/nemc/statistics_annual_report.do?brdclscd=02.