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Positive correlation between regional emergency medical resources and mortality in severely injured patients: results from the Korean National Hospital Discharge In-depth Survey

  • Hyo Jung Lee (a1) (a2), Yeong Jun Ju (a1) (a2) and Eun-Cheol Park (a1) (a3)

Abstract

Objectives

In South Korea, injury is a public health problem due to its high incidence and high mortality. To improve emergency medical systems, the government announced plans to increase the emergency medical resources for each region. This study investigated the association between regional emergency medical resources and mortality during hospitalization in severely injured inpatients.

Methods

To analyse mortality for severely injured inpatients, we used the Korean National Hospital Discharge In-depth Survey data, consisting of 18,621 hospitalizations from 2005-2012. Generalized estimating equations were analysed to examine the association between mortality during hospitalization and both individual and regional variables.

Results

Mortality during hospitalization occurred in 913 (4.9%) cases. Patients in regions with a higher number of emergency departments (odds ratio [OR]=0.94, 95% confidence interval [CI]: 0.91-0.98), a higher number of ambulances (OR=0.99, 95% CI: 0.98-0.99), and a higher number of registered nurses per emergency department (OR=0.88, 95% CI: 0.83-0.94) had a lower risk of mortality during hospitalization.

Conclusions

Our findings suggest that regional emergency medical resources are associated with a lower risk of mortality during hospitalization in severely injured patients. Thus, health care policymakers need to determine the proper distribution of emergency medical resources for each region and the function of emergency departments to provide a superior quality of emergency medical services to patients.

Objectifs

Les blessures représentent, en Corée du Sud, un problème de santé publique en raison de leur fréquence élevée et de leur mortalité importante. Afin d’améliorer les systèmes médicaux d’urgence, le gouvernement a annoncé des plans visant à accroître la disponibilité des ressources médicales d’urgence dans chaque région du pays. L’étude avait donc pour but d’examiner l’association entre les ressources médicales d’urgence en région et la mortalité en cours d’hospitalisation chez les blessés graves.

Méthode

Afin d’analyser la mortalité chez les blessés graves hospitalisés, les auteurs ont utilisé des données provenant de la Korean National Hospital Discharge In-depth Survey, portant sur 18 621 patients hospitalisés, de 2005 à 2012. L’équipe de recherche a procédé à l’analyse d’équations d’estimation généralisées afin d’examiner l’association entre la mortalité en cours d’hospitalisation et les variables tant individuelles que régionales.

Résultats

Il y a eu décès en cours d’hospitalisation dans 913 cas (4,9 %). Les patients traités dans les régions bien dotées en services des urgences (SU) (risque relatif approché [RRA]=0,94; intervalle de confiance [IC] à 95 % : 0,91-0,98), en ambulances (RRA=0,99; IC à 95 % : 0,98-0,99) et en personnel infirmier par SU (RRA=0,88; IC à 95 % : 0,83-0,94) connaissaient un risque réduit de mortalité en cours d’hospitalisation.

Conclusions

D’après les constatations de l’étude, la disponibilité des ressources médicales d’urgence en région est associée à une diminution du risque de mortalité en cours d’hospitalisation chez les blessés graves. Aussi les décideurs de politiques en matière de soins de santé doivent-ils déterminer une distribution appropriée des ressources médicales d’urgence dans chaque région et tenir compte de la fonction des SU afin d’offrir aux patients des services médicaux d’urgence de qualité.

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Copyright

Corresponding author

Correspondence to: Dr. Eun-Cheol Park, Department of Preventive Medicine, Institute of Health Services Research, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-75-2, Republic of Korea; Email: ecpark@yuhs.ac

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Positive correlation between regional emergency medical resources and mortality in severely injured patients: results from the Korean National Hospital Discharge In-depth Survey

  • Hyo Jung Lee (a1) (a2), Yeong Jun Ju (a1) (a2) and Eun-Cheol Park (a1) (a3)

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