Prospective Analysis on the Emergency Transport Systems in Pusan Area

ABSTRACT

PURPOSE: Overcrowding of emergency departments remains an unsolved international issue and has led to not a few unfavorable consequences. For a solution of this, appropriate patient triage and selection of appropriate hospitals to which to be transported will be essential. METHODS: The authors performed a prospective analysis of 690 patients transported via emergency transport services to the Emergency Department of Pusan National University Hospital between May 1, 2000 and June 30, 2000. RESULTS: Five hundred five cases (73.2%) were considered as appropriate transport, but 185 (26.8%) were not. In 300 cases (43.5%), the hospitals to which the patients were transported had been decided by the patient's family members, in 283 cases (41.0%) by medical professionals, in 70 cases (10.1%) by EMS personnels, and in 37 cases (5.4%) by the patients themselves. In the selection of the hospital to be transported to, patients and family members took the patient's medical condition into consideration less seriously than the other groups, but they had the greatest influence on the decision. CONCLUSION: The patients and their family members turned out to be unsuitable for the selection of the hospital to be transported to, but they actually had the greatest influence on the selection. The EMS personnels had limited influence on the selection, and they were lacking in ability to select appropriate hospital with the consideration of the patient's condition. For now there's no active regional ambulance destination policy or decision scheme. For the optimization of emergency transport activity, every effort should be made to enhance the role and ability of EMS personnels in patient triage and selection of transported hospital and to develope well-functioning ambulance destination policies as soon as possible.