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KMID : 1138720180440030129
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Korean Public Health Research
2018 Volume.44 No. 3 p.129 ~ p.146
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Factors Associated With Multiple Emergency Department Visits: Focused on General Hospital Level Regional Emergency Medical Center
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Lee Jung-Chan
Ahn Byeung-Ki
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Abstract
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Objectives:The purpose of this study was to find out the utilization factors of the patients who are inadequately using the regional emergency medical center(REMC) so that the patients do not use the REMC improperly.
Methods:We used nationwide general hospital level REMC visit data of 2011. Dutton(1986)'s medical use model was applied and the generalized estimation equation(GEE) method was used to analyze the factors affecting the multiple ED visit.
Results: In 2011, a total of 605,604 patients visited 733,184 times ED of REMC. We analyzed the determinants of frequent ED visit. The number of ED visit higher in males than females. By age, 30s, 50s, 40s, 9 or younger, and 10s were the most frequent users in the ED. Patients who visited the hospital with an illness rather than an accident were more likely to visit the ED. Patients with cancer or mental illness were more likely to visit the ED than those who did not. The number of ED visit was higher in the order of medical aid, auto insurance, NHI, and general patients. The number of ED visit was higher in the order of direct ED visit, referred from outpatient department, transferred from other hospitals. The number of ED visit was high in the order of personal vehicles, 119 services, private ambulances, and by walking. The number of ED visit was higher when the stay time in the ED was shorter than 60 minutes than when it was more than 60 minutes. The number of ED visit was higher in the order of Tuesday-Friday, Monday, Saturday, and Sunday. The number of ED visit was higher in the order of return home, inpatients, and transferred to other hospitals. Patients with less than triage score 9(mild) were more likely visit ED than patients with 9(severe).
Conclusion:As a result, in order to reduce the number of patients in the ED of REMC, it is necessary to continuously promote the alternative medical institutions that can be used in the local community in case of an emergency, so that the residents themselves do not use the emergency medical center. In addition, medical use of non-emergent patients should be adjusted prior to use of the hospital, and a primary health care delivery system should be established to provide community-based integrated health care services.
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KEYWORD
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Emergency Department(ED) Crowding, Regional Emergency Medical Center(REMC), Multiple ED visits, Generalized Estimation Equation(GEE)
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