Pattern of Regional Emergency Medical Service Utilization and Its Determinants

ABSTRACT

PURPOSE: This study was performed to analyze the existing patterns of regional emergency medical service utilization and to identify their determinants. METHODS: The original data consisted of the Electronic Data Interchange (EDI) claims of the National Health Insurance about the utilization of emergency medical services in 2002. The relevance index and commitment index were calculated; Then, those indices were analyzed, by using clustering analysis, to categorize the regions. A multiple-regression test identified the determinants for the relevance index and the commitment index. RESULTS: Regional relevance indices were 91.8% for Jeonju-si, 91.4% for Seoul, 91.0% for Ulsan, and 90.9% for Gumi-si, while the commitment indices were 28.0% for Guri-si, 42.9% for Masan-si, 44.0% for Gangneung-si, and 45.3% for Uijeongbu-si. Regions were categorized into inflow-type (e.g., Seoul), mixed-type (e.g., Uijeongbu-si), and outflow-type (e.g., Pyeongtaek-si) by their relevance indices and commitment indices. The determinants for the relevance index and the commitment index were analyzed, and the significant variables affecting the relevance index were the number of emergency medical doctors per 100,000 population, the proportion of general hospitals, the proportion of local and regional emergency medical centers, and administrative districts while those affecting the commitment index were the number of emergency medical doctors per 100,000 population and the proportion of general hospitals. CONCLUSION: This study is the first trial to analyze nationwide data on the utilization of emergency medical services in Korea and to identify its determinants, and it can provide a practical evidence for policy planning for the allocation of emergency medical service resources.