Abstract

Classification of Emergency Room Usage Pattern by Types of Insurance in Patients Visiting an Emergency Medical Center in Seoul Area

KIM MOO HYUN
<Department of Epidemiology and Health informatics graduate School of Public Health, Korea University >
Graduate School of Public Health, Korea University
(Supervising Professor :An Hyoung Gin Ph.D.)

Objectives : In this study, we used KTAS to analyze the medical class of patients who visited the Emergency Medical Center of H University K Hospital in Seoul. We also analyzed the characteristics and differences in patients’ medical benefits and health insurance based on severity classification. In addition, we attempted to find the ratio of non - emergency medical care patients (to emergency patients) and provide basic data and academic basic data of KTAS.

Methods : The subjects of this study were 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included KTASclassification of emergency and non-emergency ratio, type of insurance (health insurance and medical benefits), rate of rehabilitation of new and old patients, age and type of illness (illness,trauma, poisoning), and outcome (return, death, hospitalization, transportation). In addition, use of CPR, DAMA (discharge), the type of emergency, presence of DOA, duration of stay, and death were analyzed using the SPSS (Statistical Package for the Social Science) WIN 23.0 program..

Results : According to the KTAS classification, 76.2% of the patients were in an emergency condition and 23.8% were in a non ? emergency condition (p<0.001). In addition, there was a significant difference between the KTAS grades of the two groups (p<0.001). There was a significant difference between the KTAS grades of the two groups (p <.001).Emergency patients made more recurrent visits than non-emergency patients. The mean age of the emergency patients was 47.91 and the mean number of non-emergency patients was 44.64 years. The difference was statistically significant (p <.001). Emergency patients had more trauma than non-emergency patients, and non-emergency patients had more disease than emergency patients, and there were significant differences according to KTAS grade (p <.001). The results of this study showed that patients presenting with emergency conditions were hospitalized more often than non-emergency patients, and non-emergency patients returned to the emergency room more often. There were significant differences, according to KTAS grade (p <.001). The means of visiting was higher in the 119 emergency vehicles than in the non-emergency patients, and the number of patients arriving by private ambulance was higher in the non-emergency patients than in the emergency patients (p <.001). The number of emergency patients was higher than that of non-emergency patients. Non-emergency patients had more resources than emergency patients, and there were significant differences according to KTAS grade (p <.001). The type of assistance was more prevalent in emergency patients than in non-emergency patients, and non-emergency patients were more normal than those in emergency patients, with a significant difference according to KTAS grade (p <.001).




Conclusion : Although the proportion of medical care patients was significantly lower than that of health care patients, among the many causes of emergency room overcrowding, our results indicate that medical care patients contribute to the cause. Aging of the population will increase this in the future, and the contribution from patients with chronic diseases will also increase. Discussions should continue to address this situation. There is need for policy discussions that address alternative ways to replace the 119 ambulances used by patients in this study, and that identify alternative care agencies that may replace emergency room visits. In addition to policies that support chronic disease management for low-income people, policies and systems that can fundamentally prevent chronic diseases are also needed.

Key words: Korean Triage and Acuity Scale(KTAS), regional emergency medical center, insurance status