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KMID : 1013220190170010021
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Jouranl of the Korean Society of Clinical Toxicology
2019 Volume.17 No. 1 p.21 ~ p.27
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Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service
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Kim So-Young
Choi Sang-Cheon
Kim Hyuk-Hoon
Yang Hee-Won
Yoon Sang-Kyu
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Abstract
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Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning.
Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality.
Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004).
Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.
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KEYWORD
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Poisoning , Mortality , Health facility size , Insurance , Health , Reimbursement
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