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1.
Article in English | WPRIM | ID: wpr-785630

ABSTRACT

OBJECTIVE: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS).METHODS: Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics.RESULTS: Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%).CONCLUSION: Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies.


Subject(s)
Asia , Asian Continental Ancestry Group , Cross-Sectional Studies , Education , Electronic Mail , Emergencies , Emergency Service, Hospital , Epidemiology , Humans , Physician Executives , Taiwan , Thailand , Trauma Centers
2.
Article in English | WPRIM | ID: wpr-765162

ABSTRACT

BACKGROUND: This study aimed to evaluate the current overall preventable trauma death rate (PTDR) in Korea and identify factors associated with preventable trauma death (PTD). METHODS: The target sample size for review was designed to be 1,131 deaths in 60 emergency medical institutions nationwide. The panels for the review comprised trauma specialists working at the regional trauma centers (RTCs); a total of 10 teams were formed. The PTDR and factors associated with PTD were analyzed statistically. RESULTS: Of the target cases, 943 were able to undergo panel review and be analyzed statistically. The PTDR was 30.5% (6.1% preventable and 24.4% possibly preventable). Those treated at a RTC showed a significantly lower PTDR than did those who were not (21.9% vs. 33.9%; P = 0.002). The PTDR was higher when patients were transferred from other hospitals than when they directly visited the last hospital (58.9% vs. 28.4%; P = 0.058; borderline significant). The PTDR increased gradually as the time from accident to death increased; a time of more than one day had a PTDR 14.99 times higher than when transferred within one hour (95% confidence interval, 4.68 to 47.98). CONCLUSION: Although the PTDR in Korea is still high compared to that in developed countries, it was lower when the time spent from the accident to the death was shorter and the final destined institution was the RTC. To reduce PTDR, it is necessary to make an effort to transfer trauma patients to RTCs directly within an appropriate time.


Subject(s)
Developed Countries , Emergencies , Humans , Korea , Mortality , Sample Size , Specialization , Trauma Centers , Wounds and Injuries
3.
Article in Korean | WPRIM | ID: wpr-718679

ABSTRACT

PURPOSE: The social environment of easy access to medicines and arbitrary personal decisions leading to overdose aggravate unintentional medicine poisoning. This study aimed to investigate the characteristics of patients who visited emergency departments with unintentional medicine poisoning and reasons for poisoning based on age group. METHODS: We retrospectively collected patients who experienced unintentional medicine poisoning based on data from the national injury surveillance system between 2013 and 2016. Subjects were classified into three groups based on age (0-14 years, 15-64 years, and ≥65 years). We identified sex, insurance, time of poisoning, place, alcohol co-ingestion, hospitalization, death, and reason for poisoning in each age group. RESULTS: A total of 27,472 patients visited an emergency department with poisoning during the study period; 1,958 patients who experienced unintentional poisoning were enrolled in this study. Respiratory medicine was the most frequent medicine in those younger than 15 years of age, and sedatives and antipsychotic drugs were the most common in patients older than 15 years of age. In total, 35.1% of patients older than 65 years were hospitalized. The most common reasons for poisoning were careless storage of medicine in those younger than 15 years of age and overdose due to arbitrary decisions in those older than 15 years of age. CONCLUSION: Unintentional medicine poisoning has distinct characteristics based on age group, and strategies to prevent poisoning should be approached differently based on age.


Subject(s)
Antipsychotic Agents , Drug Overdose , Emergencies , Emergency Service, Hospital , Hospitalization , Humans , Hypnotics and Sedatives , Insurance , Poisoning , Pulmonary Medicine , Retrospective Studies , Social Environment
4.
Article in Korean | WPRIM | ID: wpr-714042

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the characteristics of the emergency medical services (EMS) response and clinical information on mass casualty chemical incidents in Korea. METHODS: This retrospective observational study analyzed the integrated data of the EMS rescue records and EMS-treated severe trauma registry from January 2012 to December 2013. Two databases were integrated using the unique accident identification number. Chemical incidents were defined by an in-depth review of the EMS rescue records according to a previous study. Mass casualty incidents were defined as more than 6 injured individuals. The rescue, EMS, and hospital variables of mass casualty chemical incidents were analyzed. RESULTS: A total of 8 mass casualty chemical incidents and 73 patients were included. The mean responded rescue vehicles and EMS vehicles were 2.4 and 3.5, respectively. The 4 incidents were an oil spill due to traffic accidents and most patients suffered minor trauma. A carbon monoxide leak caused the largest number of patients (23 people). The explosion caused by flammable polyethylene leaks showed the highest severity. In that explosion, the mortality rate was 40% and 8 patients had a disability at discharge. CONCLUSION: This study evaluated the characteristics of the EMS response and clinical information on mass casualty chemical incidents in Korea.


Subject(s)
Accidents, Traffic , Carbon Monoxide , Chemical Hazard Release , Emergency Medical Services , Explosions , Humans , Korea , Mass Casualty Incidents , Mortality , Observational Study , Petroleum Pollution , Polyethylene , Retrospective Studies
5.
Article in Korean | WPRIM | ID: wpr-714040

ABSTRACT

OBJECTIVE: A method of early diagnosis of acute myocardial infarction (AMI) using high-sensitivity cardiac troponin-T (hs-TnT) has been introduced. This study was conducted to evaluate the accuracy of hs-TnT in patients with suspected AMI. METHODS: Patients who were more than 20 years old with symptoms of AMI and who underwent hs-TnT and coronary angiography or echocardiography were included. Risk factors associated with AMI and basic characteristics were collected. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. The effects of time from symptom onset to emergency department (ED) visit on test accuracy were analyzed. RESULTS: The final analysis included 102 patients, of which 37 were AMI. The sensitivity and specificity of the hs-TnT was 59.5% (95% confidence interval [CI], 42.1% to 75.2%) and 67.7% (95% CI, 54.9% to 78.8%), respectively. In patients with typical chest pain, the sensitivity and specificity of the hs-TnT was 58.1% (95% CI, 39.1% to 75.5%) and 73.2% (95% CI, 57.1% to 85.8%), respectively. The NPV and sensitivity increased, and the PPV and specificity decreased as time from symptom onset to ED visit increased. CONCLUSION: The accuracy of the hs-TnT test was not as good in patients who visited the ED for symptoms suggestive of AMI. Therefore, to rule-in or rule-out AMI by using hs-TnT in ED, it is necessary to consider the electrocardiogram and clinical features, or to check variations by repeated measurement of hs-TnT.


Subject(s)
Chest Pain , Coronary Angiography , Early Diagnosis , Echocardiography , Electrocardiography , Emergencies , Emergency Service, Hospital , Humans , Methods , Myocardial Infarction , Risk Factors , Sensitivity and Specificity , Troponin , Troponin T
6.
Article in English | WPRIM | ID: wpr-713493

ABSTRACT

BACKGROUND: The purpose of this study was to identify the characteristics of injuries of school-aged children transported via emergency medical services (EMS) that occurred in schools by comparing with injuries that occurred outside of school. METHODS: Data from the 119 EMS from 2012 to 2014 were analyzed. School and non-school injuries were analyzed in children 6 to 17 years of age. The epidemiologic characteristics were assessed according to school-age groups; low-grade primary (6–8 years), high-grade primary (9–13 years), middle (13–15 years) and high (15–17 years) school. Gender-stratified multivariable logistic regression analysis was conducted to estimate the risks of school injury in each age group. RESULTS: During the study period, a total of 167,104 children with injury were transported via 119 ambulances. Of these injuries, 13.3% occurred at schools. Boys accounted for 76.9% of school injuries and middle school children accounted for a significantly greater proportion (39.6%) of school injuries (P < 0.001). The most frequent mechanisms of injury at school were falls (43.8%). The peak times for school injury occurrence were lunch time (13:00–13:59) in all age groups. Multivariate regression identified the risky age groups as high-grade primary (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.09–1.20) and middle school-aged boys (OR, 1.82; 95% CI, 1.74–1.90) and middle school-aged girls (OR, 1.30; 95% CI, 1.21–1.40). CONCLUSION: Notable epidemiologic differences exist between in- and out-of-school injuries. The age groups at risk for school injuries differ by gender.


Subject(s)
Accidental Falls , Ambulances , Child , Emergencies , Emergency Medical Services , Epidemiology , Female , Humans , Korea , Logistic Models , Lunch
7.
Article in English | WPRIM | ID: wpr-713325

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effect of alcohol use on emergency department (ED) length of stay (LOS) among minimally injured patients by mechanism of injury. METHODS: This was a retrospective study of injury surveillance data for injured patients (except poisoning), aged over 18 years, discharged home from the ED, and treated at seven academic EDs in Korea during 2008 to 2012. Patients were divided into alcohol-related and alcohol-unrelated groups based on self-report. We used multivariable quantile regression models for the analysis and adjusted covariates including age, sex, consciousness status, severity of injury, emergency medical service use, the season, day and time of visit, and hospital. To determine if there were different effects of alcohol use across mechanism of injury, all analyses were stratified by each mechanism. RESULTS: Among 192,200 patients, 95,807 patients were analyzed. The number of participants in the alcohol-related group was 16,249 (17.0%). In the multivariable quantile regression model, the alcohol-related group had significantly longer ED LOS at the 10th (7 minutes; 95% confidence interval [CI], 6 to 8), 50th (21 minutes; 95% CI, 19 to 23), and 90th (81 minutes; 95% CI, 74 to 87) percentiles when compared to the alcohol-unrelated group. The effect of alcohol use on increased ED LOS was most prominent in motor vehicle injuries. CONCLUSION: We found that alcohol use was associated with increased emergency ED LOS. Furthermore, if we limited our attention to the effect of alcohol use on the number of patients, the burden of alcohol use on the ED would have been underestimated.


Subject(s)
Consciousness , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Humans , Korea , Length of Stay , Motor Vehicles , Observational Study , Retrospective Studies , Seasons , Wounds and Injuries
8.
Article in English | WPRIM | ID: wpr-714765

ABSTRACT

OBJECTIVES: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. METHODS: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. RESULTS: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. CONCLUSIONS: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.


Subject(s)
Adolescent , Cause of Death , Emergencies , Emergency Service, Hospital , Hospitalization , Humans , Information Systems , Intention , Mortality , Motor Vehicles , Violence
9.
Article in English | WPRIM | ID: wpr-159418

ABSTRACT

Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale. Objective scenario-based competence assessment tool was used to validate the self-survey results for five life-threatening diseases presenting frequently in emergency rooms of Cameroon. Response rate of the self-survey was 82.6%. In this first half of competence assessment, knowledge of infectious disease had the highest score (4.6 ± 0.4) followed by obstetrics and gynecology (4.2 ± 0.6) and hematology and oncology (4.2 ± 0.5); in contrast, respondents rated the lowest score in the domains of disaster, abuse and assault, and psychiatric and behavior disorder (all of mean 2.8). In the scenario-based test, knowledge of multiple trauma had the highest score (4.3 ± 1.2) followed by anaphylaxis (3.4 ± 1.4), diabetic ketoacidosis (3.3 ± 1.0), ST-elevation myocardial infarction (2.5 ± 1.4), and septic shock (2.2 ± 1.1). Mean difference between the self-survey and scenario-based test was statistically insignificant (mean, −0.02; 95% confidence interval, −0.41 to 0.36), and agreement rate was 58.3%. Both evaluation tools showed a moderate correlation, and the study population had relatively low competence for specific aspects of emergency medicine and clinical procedures and skills.


Subject(s)
Anaphylaxis , Cameroon , Communicable Diseases , Curriculum , Delivery of Health Care , Developing Countries , Diabetic Ketoacidosis , Disasters , Discrimination, Psychological , Emergencies , Emergency Medicine , Emergency Service, Hospital , Gynecology , Hematology , Mental Competency , Multiple Trauma , Myocardial Infarction , Obstetrics , Professional Competence , Shock, Septic , Surveys and Questionnaires
10.
Article in English | WPRIM | ID: wpr-646627

ABSTRACT

OBJECTIVE: This study evaluated whether emergency medical service (EMS) use was associated with early arrival and admission for definitive care among intracerebral hemorrhage (ICH) patients. METHODS: Patients with ICH were enrolled from 29 hospitals between November 2007 and December 2012, excluding those patients with subarachnoid hemorrhage, traumatic ICH, and missing information. The patients were divided into four groups based on visit type to the definitive hospital emergency department (ED): direct visit by EMS (EMS-direct), direct visit without EMS (non-EMS-direct), transferred from a primary hospital by EMS (EMS-transfer), and transferred from a primary hospital without EMS (non-EMS-transfer). The outcomes were the proportions of participants within early (<1 hr) definitive hospital ED arrival from symptom onset (pS2ED) and those within early (<4 hr) admission from symptom onset (pS2AD). Adjusted odds ratios were calculated to determine the association between EMS use and outcomes with and without inter-hospital transfer. RESULTS: A total of 6,564 patients were enrolled. The adjusted odds ratios (95% confidence intervals) for pS2ED were 22.95 (17.73–29.72), 1.11 (0.67–1.84), and 7.95 (6.04–10.46) and those for pS2AD were 5.56 (4.70–6.56), 0.96 (0.71–1.30), and 2.35 (1.94–2.84) for the EMS-direct, EMS-transfer, and non-EMS-direct groups compared with the non-EMS-transfer group, respectively. Through the interaction model, EMS use was significantly associated with early arrival and admission among direct visiting patients but not with transferred patients. CONCLUSION: EMS use was significantly associated with shorter time intervals from symptom onset to arrival and admission at a definitive care hospital. However, the effect disappeared when patients were transferred from a primary hospital.


Subject(s)
Cerebral Hemorrhage , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Hospitals , Humans , Intracranial Hemorrhages , Observational Study , Odds Ratio , Patient Admission , Subarachnoid Hemorrhage, Traumatic
11.
Article in English | WPRIM | ID: wpr-648409

ABSTRACT

OBJECTIVE: Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. METHODS: We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis. RESULTS: Of 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows: no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality. CONCLUSION: Although DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.


Subject(s)
Consciousness , Delivery of Health Care , Diagnosis , Emergencies , Emergency Service, Hospital , Humans , Insurance , Insurance, Health , Mortality , Organization and Administration , Patient Discharge , Risk Factors , Voice
12.
Article in English | WPRIM | ID: wpr-643741

ABSTRACT

OBJECTIVE: We aimed to develop an International Classification of Diseases (ICD) 10th edition injury code-based disability-adjusted life year (DALY) to measure the burden of specific injuries. METHODS: Three independent panels used novel methods to score disability weights (DWs) of 130 indicator codes sampled from 1,284 ICD injury codes. The DWs were interpolated into the remaining injury codes (n=1,154) to estimate DWs for all ICD injury codes. The reliability of the estimated DWs was evaluated using the test-retest method. We calculated ICD-DALYs for individual injury episodes using the DWs from the Korean National Hospital Discharge Injury Survey (HDIS, n=23,160 of 2004) database and compared them with DALY based on a global burden of disease study (GBD-DALY) regarding validation, correlation, and agreement for 32 injury categories. RESULTS: Using 130 ICD 10th edition injury indicator codes, three panels determined the DWs using the highest reliability (person trade-off 1, Spearman r=0.724, 0.788, and 0.875 for the three panel groups). The test-retest results for the reliability were excellent (Spearman r=0.932) (P<0.001). The HDIS database revealed injury burden (years) as follows: GBD-DALY (138,548), GBD-years of life disabled (130,481), and GBD-years of life lost (8,117) versus ICD-DALY (262,246), ICD-years of life disabled (255,710), and ICD-years of life lost (6,537), respectively. Spearman’s correlation coefficient of the DALYs between the two methods was 0.759 (P<0.001), and the Bland-Altman test displayed an acceptable agreement, with exception of two categories among 32 injury groups. CONCLUSION: The ICD-DALY was developed to calculate the burden of injury for all injury codes and was validated with the GBD-DALY. The ICD-DALY was higher than the GBD-DALY but showed acceptable agreement.


Subject(s)
International Classification of Diseases , Methods , Quality-Adjusted Life Years , Weights and Measures , Wounds and Injuries
13.
Article in Korean | WPRIM | ID: wpr-168304

ABSTRACT

PURPOSE: The aim of this study was to evaluate the characteristics of Emergency Medical Service (EMS) provider responded chemical, biological, radiological, and nuclear (CBRN) incidents in Korea. METHODS: Nationwide EMS rescue records from Jan 2012 to Dec 2014 were analyzed. All EMS rescue records were integrated according to the unique accident ID. Cases related to animal rescue, hive removal, and suicide-related were excluded. CBRN-associated keywords were extracted by literature review and pilot survey. In-depth review of cases containing CBRN-associated keywords in the activity summary were conducted by trained emergency medical technicians, and predefined information was abstracted. Descriptive analyses were performed to characterize the EMS provider responded CBRN incidents. RESULTS: A total of 1,571,293 cases were included, and 1,335,205 cases had a unique accident ID; 515,417 cases were excluded because of their association with animal rescue, hive removal, and suicide attempts; 19,663 cases contained CBRN-associated keywords in the activity summary, and in-depth review identified 1,862 cases as CBRN incidents. Among them 1,856 cases were chemical incidents, and 6 cases were radiological incidents; 144 cases were resulted to victims. In chemical incidents, ammonia, hydrogen chloride, sulfuric acid, hydrogen fluoride, and nitric acid were the top 5 toxic substances. In chemical incidents with victims, the proportion of explosion/implosion, and suffocation in sealed space was more prevalent than chemical incidents without victims. Median scene time of all CBRN incidents was 41 minutes (interquartile range 18.0-57.0). CONCLUSION: We evaluated the characteristics of CBRN incidents responded by EMS in Korea.


Subject(s)
Ammonia , Animals , Asphyxia , Biohazard Release , Chemical Hazard Release , Emergencies , Emergency Medical Services , Emergency Medical Technicians , Humans , Hydrochloric Acid , Hydrofluoric Acid , Korea , Nitric Acid , Radioactive Hazard Release , Suicide , Sulfur
14.
Article in English | WPRIM | ID: wpr-85714

ABSTRACT

To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs' epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved > or = 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6-5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals' resources.


Subject(s)
Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Biohazard Release/statistics & numerical data , Chemical Hazard Release/statistics & numerical data , Child , Child, Preschool , Cross-Sectional Studies , Databases, Factual , Emergency Medical Services , Female , Hospitals , Humans , Infant , Infant, Newborn , Male , Mass Casualty Incidents/statistics & numerical data , Middle Aged , Retrospective Studies , Young Adult
15.
Article in English | WPRIM | ID: wpr-141171

ABSTRACT

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.


Subject(s)
Abortion, Induced/statistics & numerical data , Adult , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Disabled Persons/statistics & numerical data , Female , Humans , Mothers/statistics & numerical data , Pregnancy , Pregnancy Complications , Prenatal Care/statistics & numerical data , Republic of Korea , Young Adult
16.
Article in English | WPRIM | ID: wpr-141170

ABSTRACT

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.


Subject(s)
Abortion, Induced/statistics & numerical data , Adult , Cesarean Section/statistics & numerical data , Delivery, Obstetric/statistics & numerical data , Disabled Persons/statistics & numerical data , Female , Humans , Mothers/statistics & numerical data , Pregnancy , Pregnancy Complications , Prenatal Care/statistics & numerical data , Republic of Korea , Young Adult
17.
Article in Korean | WPRIM | ID: wpr-115327

ABSTRACT

PURPOSE: A trauma protocol for transport bypassing hospital for severe trauma patients was developed and implemented in Korea in 2012 using the field triage decision scheme of Centers for Disease Control and Prevention of US. The aim of this study is to evaluate the compliance with the protocol in severe trauma between metropolitan versus non-metropolitan area. METHODS: Severe trauma patients were identified by the new protocol and collected from a trauma registry and EMS run sheet in one metropolitan and one non-metropolitan province from October 2012 (one month). Data variables included demographic, clinical information on vital signs and mental status, injury related variables like mechanisms, geographic information on place of the event, and distance to nearest, bypassed, and destination hospitals. Exposures are metropolitan versus non-metropolitan ambulances defined. Study end point was compliance-direct transport (C-DT), compliance-bypassing transport (C-BT), violation-non-bypassing transport (V-NT), and violation-bypassing transport (V-BT). The protocol violation with number of V-NT and V-BT divided by number of eligible patients were compared between metropolitan and non-metropolitan ambulances. RESULTS: Of the 863 patients with severe trauma were identified by the protocol. No statistical difference in demographics and clinical parameters except injury mechanism and distance to destination hospital. Between metropolitan versus non-metropolitan area. The C-DT, C-BT, V-NT, and V-BT were 27.4%, 18.5%, 20.2%, and 33.4% respectively. V-NT rate was significantly lower in metropolitan than in nonmetropolitan (8.2% versus 30.6%, p=0.001), while V-BT rate was significantly higher in metropolitan than in non-metropolitan (46.2% versus 23.3%, p=0.001), respectively. CONCLUSION: Protocol violation rates were significantly different in non-bypassing and inappropriate bypassing to hospital between metropolitan versus non-metropolitan ambulances when using the bypassing hospital trauma protocol.


Subject(s)
Ambulances , Compliance , Demography , Emergency Medical Services , Humans , Korea , Multiple Trauma , Transportation , Triage , Vital Signs
18.
Article in English | WPRIM | ID: wpr-9596

ABSTRACT

PURPOSE: This study attempted to examine parental satisfaction with pediatric emergency care (PEC) in Korea and investigate the features influencing overall satisfaction. METHODS: A nationwide, cross-sectional survey was conducted among parents who had taken their children to an Emergency Department (ED) in the three years prior to the study. A 21-item, structured questionnaire was administered to the parents through a web-based system. Participants' satisfaction levels and the strength of the association between PEC components and overall satisfaction were rated using a 7-point Likert scale. RESULTS: In total, 1,000 parents participated in the survey, of which 402 (40.2%) stated that they were generally satisfied with the delivered PEC. Female participants, mothers, and parents with low-acuity patients were more likely to be dissatisfied with the delivered PEC. Although the ED environment was the lowest level of satisfaction, it did not significantly influence the respondents' overall levels of satisfaction. The most influential factors in terms of overall satisfaction were "nurses' professionalism" and "doctors' attitude and proper explanation". CONCLUSION: Parents' overall level of satisfaction with PEC is relatively low and is closely related to factors associated with ED personnel.


Subject(s)
Child , Cross-Sectional Studies , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Female , Humans , Korea , Mothers , Parents , Personal Satisfaction
19.
Article in Korean | WPRIM | ID: wpr-226424

ABSTRACT

The effects of disasters have recently become an important worldwide health issue. In Korea, there have been many disaster events since 2000. Recently, there was a consensus to develop a scientific research framework for disaster. According to this consensus, disaster is defined as an event associated with more than 10 deaths or more than 50 injured individuals. Besides the mortality rate of the event, the early or late mortality rate can also be used to analyze the effect of disasters. According to international and domestic databases, technical disasters have increased and become potentially deadly. Common natural causes of disaster are storms and floods and common human-made causes are fire and transportation accidents. Most disaster studies are retrospective and observational. The mortality rate of disasters ranges from 0% to 77.7%. To analyze the effect of disaster on health and to establish appropriate health policies, epidemiological research into disaster is essential.


Subject(s)
Consensus , Disaster Medicine , Disaster Victims , Disasters , Epidemiology , Fires , Floods , Health Policy , Korea , Mortality , Retrospective Studies , Transportation
20.
Article in English | WPRIM | ID: wpr-200216

ABSTRACT

We aimed to determine the scientific framework for research on disaster and mass casualty incident (MCI) in Korea, especially Korean terminology, feasible definition, and epidemiologic indices. The two staged policy Delphi method was performed by instructors of National Disaster Life Support (NDLS(R)) with the constructed questionnaire containing items based on the literature review. The first-stage survey was conducted by 11 experts through two rounds of survey for making issue and option. The second-stage survey was conducted by 35 experts for making a generalized group based consensus. Experts were selected among instructors of National Disaster Life Support Course. Through two staged Delphi survey experts made consensus: 1) the Korean terminology "jaenan" with "disaster" and "dajung-sonsang-sago" with "MCI"; 2) the feasible definition of "disaster" as the events that have an effect on one or more municipal local government area (city-county-district) or results in > or = 10 of death or > or = 50 injured victims; 3) the feasible definition of MCI as the events that result in > or = 6 casualties including death; 4) essential 31 epidemiologic indices. Experts could determine the scientific framework in Korea for research on disaster medicine, considering the distinct characteristics of Korea and current research trends.


Subject(s)
Adult , Disaster Planning , Female , Humans , Male , Mass Casualty Incidents/classification , Surveys and Questionnaires , Republic of Korea , Terminology as Topic
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