DOI QR코드

DOI QR Code

Analysis of the Use of Ambulance Services Among Pregnant, Childbearing, and Postpartum Women Using Data from the Korea Health Panel

한국의료패널을 이용한 구급 이송 서비스 이용 특성 분석: 임신, 출산, 산후기 여성을 중심으로

  • Received : 2019.09.23
  • Accepted : 2019.10.22
  • Published : 2019.12.31

Abstract

This study examined the socio-economic and clinical characteristics associated with the use of ambulance services among pregnant, childbearing, and postpartum women based on data from the 2008-2016 Korea Health Panel. The analysis revealed that among the pregnant, childbearing, and postpartum women, the proportion using all ambulance services was 18.9% whereas 12.0% used private and 119 ambulances. Moreover, among those using ambulance services, delivery was the most common reason (38.7%) followed by complications of labor and delivery (20.0%) and pregnancy with abortive outcome (17.3%). There were statistically significant differences between the users and non-users of ambulance services in terms of the average annual household income, emergency arrival time, and delayed arrival at the emergency room. As childbirth becomes more complicated due to low fertility and elderly mothers, the expansion and improvement of ambulance services as a social safety net for pregnant, childbearing, and postpartum women will become increasingly important.

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008-2016년 연간 데이터(Version 1.5)를 이용해 임신, 출산, 산후기 여성의 구급 이송 서비스 이용 특성을 분석하였다. 분석 결과를 요약하면, 첫째, 임신, 출산 및 산후기 여성의 119 구급차, 민간 구급차 등 구급 이송 서비스 이용률은 12.0%로 전체 구급 이송 서비스 이용률 18.9%보다 상대적으로 낮았다. 둘째, 임신, 출산 및 산후기 여성의 응급에서 분만이 38.7%로 가장 큰 비중을 차지하였으며, 진통 및 분만의 합병증이 20.0%, 유산된 임신이 17.3% 등의 순으로 나타났다. 셋째, 임신, 출산 및 산후기 여성의 구급 이송 서비스 이용 특성 중 연 평균 가구소득, 응급실 도착 소요시간, 응급실 도착 지연 인식 등에서 구급 이송 서비스의 이용자 집단과 비이용자 집단 사이에 통계적으로 유의한 차이가 나타났다. 따라서 저출산과 고령 산모로 인하여 분만 취약지가 늘어날수록 임신, 출산, 산후기 여성을 위한 사회안전망으로서 구급 이송 서비스의 양적 확대와 질적 제고는 더욱 시급한 과제가 될 것이다.

Keywords

References

  1. JoongAng Ilbo, "Safe Birth 119 Service for Pregnant Women in Rural Areas without Obstetrics and Gynecology ... 300 Pople Tansferred in 7 Mnths", Available from https://news.joins.com/ article/23520868 (accessed July 26, 2019).
  2. Gangwon Fire Headquarters, "Safe Delivery, Operation of 119 Call Service", Press release, March 11 (2019).
  3. Gyoungsangnam-do Fire Department, "Safe Birth 119 Service without Obstetrics and Gynecology", Available from http://www.gnfire.go.kr/gnfire/na/ntt/selectNttInfo.do?nttSn=19429 (accessed June 26, 2019).
  4. National Fire Agency, "119 Emergency Medical Technicians Expanded the Scope of On-site emergency treatment", Press Release, July 1 (2019).
  5. National Emergency Medical Center, "2017 Statistical Yearbook of Emergency Medicine", Korea (2018).
  6. National Fire Agency, "2018 Statistical Yearbook of Emergency Medical Transport Services", Korea (2018).
  7. S. Y. Oh, "The Collapse of Infrastructure for Childbirth: Causes and Consequences", Journal of the Korean Medical Association, Vol. 59, No. 6, pp. 417-423 (2016). https://doi.org/10.5124/jkma.2016.59.6.417
  8. Statistics Korea, "Birth Statistics for 2018 (confirmed)", Press release, August 28 (2019).
  9. Ministry of Health and Welfare, "2019 Information on the Project to Support Areas with Weak Childbirth" (2018).
  10. Doctor's News, "Just Shut Barely Maintained Obstetric Clinics?", Available from http://www.doctorsnews.co.kr/news/articleView.html?idxno=129575 (accessed June 26, 2019).
  11. J. Scott, "Obstetric transport", Obstetrics and Gynecology Clinics, Vol. 43, No. 4, pp. 821-840 (2016).
  12. S. Joo, "Establishing an Emergency Maternal Transport Control Center", J. Korean Soc. Matern. Child Health, Vol. 22, No 1, pp. 1-6 (2018).
  13. Korea Institute for Health and Social Affairs, National Health Insurance, Korea Health Panel, Available from http://www.khp.re.kr/ (accessed April 10, 2019).
  14. Korea Institute for Health and Social Affairs, National Health Insurance, "2016 Korea Health Panel: Basic Analysis Report (1)", Research Report 2018-1-0007, Korea (2018).
  15. K. Jang, K. Kang, Y. Jang and K. Hahn, "Analysis of the Time Intervals in 119 Ambulance Services", Fire Science and Engineering, Vol. 30, No. 4, pp. 128-134 (2016). https://doi.org/10.7731/KIFSE.2016.30.4.128
  16. S. Y. Jung, J. Suh, M. I. Cha and K. Y. Jung, "Status and Analysis of the Accidental Out-of-Hospital Deliveries Transferred by Emergency Medical Service Providers", Journal of The Korean Society of Emergency Medicine, Vol. 28, No. 3, pp. 240-247 (2017).
  17. M. L. Baek, "Analysis on Prehospital Care of Emergency Labor Pain, Vaginal Bleeding and Sexual Assault Patients by 119 Emergency Medical Technicians", The Korean Journal of Emergency Medical Services, Vol. 17, No. 2, pp. 9-20 (2013). https://doi.org/10.14408/KJEMS.2013.17.2.009
  18. S. Singh, P. Doyle, O. Campbell, M. G. Rao and G. Murthy, "Pregnant Women Who Requested a '108' Ambulance in Two States of India", BMJ Global Health, Vol. 3, No. 3, e000704 (2018). https://doi.org/10.1136/bmjgh-2017-000704
  19. M. Sultan, Y. Abebe, A. Tsadik, C. Jennings and N. MouldMillman, "Epidemiology of Ambulance Utilized Patients in Addis Ababa, Ethiopia", BMC Health Services Research, Vo. 18, No. 1, p. 997 (2018). https://doi.org/10.1186/s12913-018-3820-4
  20. O. Oguntunde, F. Yusuf, J. Nyenwa, D. Dauda, A. Salihu and I. Sinai, "Emergency Transport for Obstetric Emergencies: Integrating Community-level Demand Creation Activities for Improved Access to Maternal, Newborn, and Child Health Services in Northern Nigeria", International Journal of Women's Health, Vol. 10, p. 773 (2018). https://doi.org/10.2147/IJWH.S180415
  21. A. Wilson, S. Hillman, M. Rosato, J. Skelton, A. Costello J. Hussein, C. MacArthur and A. Coomarasamy, "A Systematic Review and Thematic Synthesis of Qualitative Studies on Maternal Emergency Transport in Low-and Middle-income Countries", International Journal of Gynecology & Obstetrics, Vol. 22, No. 3, pp. 192-201 (2013).
  22. B. Flanagan, B. Lord and M. Barnes, "Is Unplanned Out-of-hospital Birth Managed by Paramedics 'Infrequent', 'Normal' and 'Uncomplicated'?", BMC Pregnancy and Childbirth, Vol. 17, No. 1, p. 436 (2017). https://doi.org/10.1186/s12884-017-1617-9
  23. A. C. J. Ravelli, K. J. Jager, M. H. De Groot, J. J. H. M. Erwich, G. C. Rijninks-van Driel, M. Tromp, M. Eskes, A. Abu-Hanna et al., "Travel Time from Home to Hospital and Adverse Perinatal Outcomes in Women at Term in the Netherlands", BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 118, No. 4, pp. 457-465 (2011). https://doi.org/10.1111/j.1471-0528.2010.02816.x
  24. K. Noh, J. Jeong, Y. J. Kim, J. E. Rhee, J. S. Hong and K. H. Park, "The Effect and Satisfaction Level of an Out-of-hospital Delivery and Neonatal Care Education Program for Emergency Medical Service Providers", Journal of the Korean Society of Emergency Medicine, Vol. 24, No. 6, pp. 674-683 (2013)