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KMID : 1140520230270030007
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Korean Journal of Emergency Medical Services
2023 Volume.27 No. 3 p.7 ~ p.16
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Comparing the outcomes of out-of-hospital cardiac arrest between national health insurance and medical aid in Seoul before and during COVID-19 pandemic
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Lee Kyoung-Youl
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Abstract
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Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul.
Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery.
Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19.
Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.
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KEYWORD
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Out-of-hospital cardiac arrest, National health insurance, Medical aid, COVID-19
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