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KMID : 1138720230490010011
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Korean Public Health Research
2023 Volume.49 No. 1 p.11 ~ p.23
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The Differences and Determinants in Mortality of Elderly Patients visiting emergency department by regional types in Busan-Ulsan-Gyeongnam
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Yun Hyun-Jun
Kim Kil-Hun
Lee Myoung-Hwa
Ryu Ji-Ho
Yang Wook-Tae
Yeom Seok-Ran
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Abstract
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Objectives: This study is conducted to classify regional types and identify determinants in mortality of elderly patients visiting emergency department.
Methods: From 2017 to 2019, the ecological characteristics of 43 local governments(which belong to Busan Metropolitan City, Ulsan Metropolitan City, and Gyeongsangnam-do) are collected. We classify the regional types through cluster analysis. The differences about mortality and determinants by region type are confirmed using t-test. The influences of factors are confirmed through multiple regression analysis.
Results: Clusters are classified as city group and non-city group, and the mortality of elderly patients visiting ED is high in non-city group. In all, city group, and non-city group, ED TRI(Timely Relevance Index) is significant about mortality of elderly patients visiting ED. The determinants in the mortality are significant as follows. In the order of influence on the mortality, All: Visit(holiday&weekend)(-), Regional emergency medical center(-), KTAS 1, 2(+), Local emergency medical agency(and over)(-), Financial independence(+), Oldest-old(+), Acute myocardial infarction(+), City group: KTAS 1, 2(+), Local emergency medical agency(and over)(-), Leisure Center(-), Care institutions(+), Medical care(-), Residential facilities(-), Non-city group: Oldest-old(+), Health facilities(+), Factory(+), Local emergency medical agency(and over)(-), Visit(night)(+), Acute stroke(+), Local emergency medical center(and over)(-), In-home care facilities(-)
Conclusion: In order to improve the mortality rate of elderly patients visiting ED, the most urgent task is to improve access to ED regardless of region type, and it will be necessary to expand infrastructure and introduce new technologies. Considering the characteristics of each regional type, prevention and health promotion activities, and expansion of elderly welfare facilities are also important tasks.
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KEYWORD
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Elderly, Emergency Department, Mortality, Regional Disparity, Health Care Access
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