Factors affecting use of the emergency department at superior hospitals on public holidays

상급종합병원 응급실 공휴일 이용의 영향 요인

  • Received : 2018.08.15
  • Accepted : 2019.02.26
  • Published : 2019.03.30

Abstract

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

Keywords

References

  1. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.247-250, pp.331.
  2. Byeung Ki Ahn. Appearance on the utilization of Hospital Admissions Decided by Patients or Their Families, The Korean Journal of Health Economics and Policy, 2017;23(3):87-105.
  3. Jae Yong Park. The Factors Affecting Patient-Flow. Korean J. of Health Policy & Administration, 3(2), 1993, pp.57-80.
  4. Fox DM(1998), Health Policy and the History of Welfare State: a Reinterpretation, Journal of Policy History, 10(2):239-256. https://doi.org/10.1017/S0898030600005625
  5. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.10. pp.430. pp.446.
  6. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.430. pp.452.
  7. Byeung Ki Ahn. Factors Affecting Patients Frequently Using the Emergency department. 2019 Korea's Allied Economic Associations Annual Meeting; 2019 February 14-15; seoul, Korea. [cited 2019 March. 28] Available from https://goo.gl/6sL9nG.
  8. Emergency room overcrowding. Ministry of Health and Welfare.National Medical Center. 2017 April 4.
  9. An emergency room that does not perform well because of non-emergency patients [Internet]. seoul: rapportian; 2012 [cited 2018 August. 15] Available from http://www.rapportian.com/news/articleView.html?idxno=6906
  10. The Ministry of Health and Welfare will solve the problem of overcrowding in pediatric emergency room [Internet]. seoul: medicaltimes; 2018 [cited 2018 August. 15] Available from http://www.medicaltimes.com/Users/News/newsPrint.html?ID=1076546
  11. Tintinalli JE. Analysis of insurance payment denials using the prudent layperson standard. Annals of emergency medicine. 2000;35:291-4. https://doi.org/10.1016/S0196-0644(00)70083-7
  12. Sempere-Selva T, Peiro S, Sendra-Pina P, Martinez-Espin C, Lopez-Aguilera I. Inappropriate use of an accident and emergency department: magnitude, associated factors, and reasons-an approach with explicit criteria. Ann Emerg Med 2001;37(6):568-79. https://doi.org/10.1067/mem.2001.113464
  13. Alessio Vedovetto, Nicola Soriani, Emanuela Merlo, and Dario Gregori(2014). The Burden of Inappropriate Emergency Department Pediatric Visits: Why Italy Needs an Urgent Reform. Health Services Research, 49(4):1290-1305. https://doi.org/10.1111/1475-6773.12161
  14. Philip McHale. Sara Wood, Karen Hughes, Mark A Bellis, Ulf Demnitz and Sacha Wyke(2013). Who Uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Medicine, 11:258. https://doi.org/10.1186/1741-7015-11-258
  15. National Emergency Department Information System(NEDIS) Statistical Yearbook. Ministry of Health and Welfare.National Medical Center, 2016.pp.54-134.
  16. National Emergency Department Information System(NEDIS) Statistical Yearbook. Ministry of Health and Welfare.National Medical Center, 2017.pp.46.
  17. Kyu Sik Lee, Young Suk Shin, Chan Woo Kim. A community-centric integrated care of health and social care. Health and Welfare Policy Institute. 2017.4.13;21.
  18. Hyung Sun Jeong, Byung Ho Choi, Young seok Shin, Procurement and management of health insurance finances. Ministry of Health and Welfare, 2017.June.30.
  19. Cancer patients are also treated at home [Internet]. seoul: chosunBiz; 2019 [cited 2019 January 4] Available from http://m.biz.chosun.com/svc/article.html?contid=2019010302029&related_m_all
  20. Take care of a patient at home [Internet]. seoul: Etnews; 2016 [cited 2016 July 3] Available from www.etnews.com/20160701000184
  21. Curtis L. Unit costs of social care. Personal Social Services Research Unit. 2007.
  22. Sadowski LS, Kee RA, VanderWeele TJ, et al. Effect of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: a randomized trial. JAMA 2009;301:1771-8. https://doi.org/10.1001/jama.2009.561
  23. Whiticar R, Webb H, Smith S. Re-attendance to the emergency department. Emerg Med J 2008;25:360-1. https://doi.org/10.1136/emj.2007.050617
  24. Darzi A. A framework for action. 2007.
  25. George G, Jell C, Todd BS. Effect of population ageing on emergency department speed and efficiency: a historical perspective from a district general hospital in the UK. Emerg Med J 2006;23:379-83. https://doi.org/10.1136/emj.2005.029793
  26. McCusker J, Verdon J. Do geriatric interventions reduce emergency department visits? A systematic review. J Gerontol A Biol Sci Med Sci 2006;61:53-62. https://doi.org/10.1093/gerona/61.1.53
  27. Bentley J, Meyer J. Repeat attendance by older people at accident and emergency departments. J Adv Nurs 2004:48;149-56. https://doi.org/10.1111/j.1365-2648.2004.03182.x
  28. National Institute for Clinical Studies(NICS). National emergency department collaborative report. Melbourne: NICS, 2004.
  29. Hansagi H, Olsson, M, Sjoberg S, et al. Frequent use of the hospital emergency department is indicative of high use of other health care services. Ann Emerg Med 2001;37:561-7. https://doi.org/10.1067/mem.2001.111762
  30. Okin RL, Boccellari A, Azocar F, et al. The effects of clinical case management on hospital service use among ED frequent users. Am J Emerg Med 2000;18:603-8. https://doi.org/10.1053/ajem.2000.9292
  31. Pope D, Fernandes CM, Bouthillette F, et al. Frequent users of the emergency department: a program to improve care and reduce visits. CMAJ 2000; 162:1017-20.
  32. Ministry of Community Development. interministerial committee on ageing report. Singapore: Ministry of Community Development, 1999.
  33. Emergency room does not have empty bed on holiday [Internet]. seoul: naver; 2018 [cited 2018 August.15] Available from http://blog.naver.com/PostView.nhn?blogId=sechsi&logNo=221175764006
  34. Joonbum Park, Taeho Lim. Korean Triage and Acuity Scale(KTAS), The Korean Society of Emergency Medicine, 2017;28(6):547-552.
  35. Prehospital Canadian Triage and Acuity Scale: paramedic guide. 2th ed. Ontario: Ministry of Health and Long-Term Care; 2014.
  36. II Jae Wang, Suck Ju Cho, Seok Ran Yeom, Byung Kwan Bae, Young Mo Cho, Kang Ho Lee, Mi Jung Kim, Seong Yeon Hwang, Jae Seong Park, Relationship between emergency department disposition, level of emergency base on Korean Triage and Acuity Scale(KTAS), Visit Mode, Journal of The Korean Society of Emergency Medicine. 2018:29(2):7-15.xc
  37. Report on the Awareness and Satisfaction Survey of Emergency Medical Services in 2014, Hyundai Research Institute. 2014.pp.56.
  38. National Emergency Department Information System(NEDIS) Statistical Yearbook. Ministry of Health and Welfare.National Medical Center, 2017.pp.46.
  39. Byeung Ki Ahn, Factors Affecting Cost-Sharing Charges for Inpatients, Korean J. of Health Policy & Administration, 2012:22(3):451-465. https://doi.org/10.4332/KJHPA.2012.22.3.451
  40. Dutton D. Financial, organizational and professional factors affecting health care utilization. Social Science and Medicine 1986;23(7): 721-735. https://doi.org/10.1016/0277-9536(86)90121-8
  41. Byeung Ki Ahn, Jae Yong Park. Determinants on the utilization of Upper Grade Ward. Journal of Health Economics and Policy 2011;17(4):69-88.
  42. Byeung Ki Ahn, Jae Yong Park. Determinants of selecting a doctor in specialized medical institutions and general hospitals. Journal of Health Policy & Administration 2011;599-616.
  43. Byeung Ki Ahn. Determinants on the utilization of Upper Grade Ward and Medical Expenditure. Kyungpook National University 2011.
  44. Andersen, R., Newman, F., Societal and individual determinants of medical care utilization in the United States, Milbank Mem Fund Q 51, 1973:95-124. https://doi.org/10.2307/3349613
  45. Soria-Aledo, V., Carrillo-Alcaraz, A., Flores-Pastor, B., Moreno-Egea, A., Carrasco-Prats, M., & Aguayo-Albasini, J. L., ʻReduction in inappropriate hospital use based on analysis of the causesʼ, BMC health services research, 12(1), 2012, p.361. https://doi.org/10.1186/1472-6963-12-361
  46. National Emergency Department Information System(NEDIS) Statistical Yearbook. Ministry of Health and Welfare.National Medical Center, 2017.pp.48-51.
  47. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.140.
  48. Higher grade general hospital 42 designation, 1 reservation. Ministry of Health and Welfare. 2017 December 26.
  49. Euichul Shin et al. Study on proper hospitalization management plan for new diagnosis related group based payment. Health and Welfare Policy Institute.HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE. 2016, December.
  50. Six minutes to live or die [Internet]. USA: USA TODAY; 2019 [cited 2019 March 28] Available from http://www.usatoday.com/news/nation/ems-day2-directors.htm
  51. Let's use an ambulance properly [Internet]. Japan: FDMA; 2019 [cited 2019 March 28] Available from https://www.fdma.go.jp/publication/portal/items/portal002_korean.pdf
  52. Fatovich DM, Hirsch RL. Entry overload, emergency department overcrowding, and ambulance bypass. Emerg Med J. 2003; 20: 406-9. https://doi.org/10.1136/emj.20.5.406
  53. Joonbum Park, Taeho Lim. Korean Triage and Acuity Scale(KTAS), The Korean Society of Emergency Medicine, 2017;28(6):547-552.
  54. Call 111 for non-emergency medical advice [Internet]. England: NHS; 2018. [cited 2018 August.15] Available from http://www.nhs.uk/pages/home.aspx
  55. why do I have to wait so long to be seen in the emergency room [Internet]. U.S.News: 2019. [cited 2019 January 10] Available from https://health.usnews.com/health-care/patient-advice/articles/2018-10-26/why-do-i-have-to-wait-so-long-to-be-seen-in-the-emergency-room
  56. Focusing on development plan for hospital future medical care [Internet]. seoul: Medical news; 2019 [cited 2016 october 7] Available from http://www.bosa.co.kr/news/articleView.html?idxno=609970
  57. Telemedicine Is A Game-Changer For Patients, The System [Internet]. 2019 [cited 2019 March 28] Available from http://www.forbes.com/sites/billfrist/2015/03/12/telemedicine-is-a-game-changer-for-patients-the-system/#3b996fe7e301
  58. Hyun Woong Shin, Byung Ho Choi, Kyu Sik Lee, Hyung Chung Jong, Sang Young Lee et al. The policy and strategy for the development of Future Health care plan. Korea Institute for Health and Social Affairs. 2015: 68.
  59. Kyu Sik Lee, Medical Security, Company gyechungmun, 2019, pp.203-205, pp.585.
  60. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.148.
  61. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.138-152.
  62. Jungchan Lee, ByeungKi Ahn, Factors Associated With Multiple Emergency Department Visits: Focused on General Hospital Level Regional Emergency Medical Center, 2018, pp.129-146.
  63. Kyu Sik Lee, New Paradigm for Healthcare Policies, Company gyechungmun, 2018, pp.298.
  64. Tae Hyung Han, Byung Jin Cho, Baek Hyo Shin. Behavior Patterns of Health Care Utilization in Terminal Cancer Patients. Korean Journal of pain. 1999;12(1):101-107.45.