Fire Science and Engineering (한국화재소방학회논문지)

Korean Institute of Fire Science and Engineering (한국화재소방학회)
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Ambulance Service Use by Elderly Adults: Based on 2008~2011 Korea Health Panel Data

노인의 구급 이송 서비스 이용 특성과 영향 요인: 한국의료패널 2008~2011년 자료를 중심으로

  • Received : 2015.07.08
  • Accepted : 2015.09.22
  • Published : 2015.10.31
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Abstract

This study investigates the socio-economic and clinical characteristics associated with emergency medical transport use by the elderly based on 2008~2011 Korea Health Panel data. A model of emergency medical transport use was analyzed, and the results indicate that use of 119 ambulances and private ambulances by the elderly accounted for 46.8% of all users, and 35.1% of their emergency room visits. Statistically significant factors associated with emergency medical transport use were gender (OR = 2.19, 95% CI = 1.51-3.17), relationship to household (OR = 2.19, 95% CI = 1.45-3.32), insurance type (OR = 1.41, 95% CI = 1.10-1.82), handicap (OR = 1.44, 95% CI = 1.14-1.83), reason for emergency department visits (OR = 1.53, 95% CI = 1.20-1.97), and treatment after emergency medical service completed (OR = 3.45, 95% CI = 2.80-4.25). The increased elderly population in an aging society will lead to a surge in demand for emergency patient transport services, and emergency medical services that are tailored to the elderly need to be developed accordingly.

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008~2011년 연간 데이터(Version 1.0)을 이용해 노인의 구급 이송 서비스 이용 특성과 관련 요인을 파악하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등의 구급 이송 서비스를 이용한 노인은 전체 이용자의 46.8%를 차지하며, 응급실을 방문한 노인의 35.1%가 구급 이송 서비스를 이용했다. 둘째, 노인의 구급 이송 서비스 이용은 성별 중 남성(OR = 2.19, 95% CI = 1.51~3.17), 가구주와의 관계 중 배우자(OR = 2.19, 95% CI = 1.45~3.32), 의료 보장 형태 중 의료 급여(OR = 1.41, 95% CI = 1.10~1.82), 장애가 있는 경우(OR = 1.44, 95% CI = 1.14~1.83), 응급실 방문 이유 중 사고/중독(OR = 1.53, 95% CI = 1.20~1.97), 응급실 이용 후 조치 중 입원/전원(OR = 3.45, 95% CI = 2.80~4.25)이 통계적으로 유의한 영향 요인으로 나타났다. 따라서 고령화 시대에 노인 인구의 증가는 구급 이송 서비스의 수요 급증으로 이어질 것이며, 이에 따른 노인 맞춤형 응급의료 서비스 등의 개발이 필요하다.

Keywords

References

  1. Statistics Korea, Population Projections for Korea: 2010-2060 (Based on the 2010 Census), Korea (2011).
  2. J. I. Kim, "Levels of Health-related Quality of Life (EQ-5D) and its Related Factors among Vulnerable Elders Receiving Home Visiting Health Care Services in Some Rural Areas", J Korean Acad Community Health Nurs, Vol. 24, No. 1, pp. 99-109 (2013). https://doi.org/10.12799/jkachn.2013.24.1.99
  3. F. Aminzadeh and W. B. Dalziel, "Older Adults in the Emergency Department: A Systematic Review of Patterns of Use, Adverse Outcomes, and Effectiveness of Interventions", Annals of Emergency Medicine, Vol. 39, No. 3, pp. 238-247 (2012). https://doi.org/10.1067/mem.2002.121523
  4. R. W. Derlet, J. R. Richards and R. L. Kravitz, "Frequent Overcrowding in US Emergency Departments", Academic Emergency Medicine, Vol. 8, No. 2, pp. 151-155 (2001). https://doi.org/10.1111/j.1553-2712.2001.tb01280.x
  5. S. J. Wang, "Geriatric Emergency Medicine", Proceedings of the Korean Society of Emergency Medicine, Vol. 2013, No. 1, pp. 77-79 (2013).
  6. D. C. Roberts, M. P. McKay and A. Shaffer, "Increasing Rates of Emergency Department Visits for Elderly Patients in the United States, 1993 to 2003", Annals of Emergency Medicine, Vol. 51, No. 6, pp. 769-774 (2008). https://doi.org/10.1016/j.annemergmed.2007.09.011
  7. T. F. Platts-Mills, B. Leacock, J. G. Cabaῇas, F. S. Shofer and S. A. McLean, "Emergency Medical Services Use by the Elderly: Analysis of a State Database", Prehospital Emergency Care, Vol. 14, No. 3, pp. 329-333 (2010). https://doi.org/10.3109/10903127.2010.481759
  8. D. S. Lee, H. S. Chi, B. R. Kim and K S. Lee, "The Analysis of Emergency Patients", Journal of the Korean Surgical Society, Vol. 35, No. 4, pp. 371-379 (1988).
  9. National Emergency Medical Center, 2012 Statistical Yearbook of Emergency Medicine, Korea (2013).
  10. National Emergency Management Agency. 2013 Statistical Yearbook of Emergency Medical Transport Services, Korea (2013).
  11. S. W. Park, B. K. Lee, H. H. Ryu, K. M. Jeung and T. Heo, "Out-of-Jurisdiction Transport of Patients by the 119 Rescue Group", Journal of the Korean Society of Emergency Medicine, Vol. 21, No. 5, pp. 531-538 (2010).
  12. E. K. Lee and E. J. Ji, "Analysis of Older Patients Using a Regional Emergency Center", J Korean Gerontol Nurs, Vol. 11, No. 1, pp. 71-80 (2009).
  13. B. O. Lee and E. J. Shin, "Severity of Elderly Patients Using One Region Wide Emergency Medical Center", J. Korean Gerontol Nurs, Vol. 10, No. 2, pp. 164-172 (2008).
  14. H. J. Cho, D. H. Kim, K. S. Han, J. S. Park, S. W. Moon, S. W. Lee, S. H. Choi and Y. S. Hong, "Analysis of Emergency Department Patients Transferred from Geriatric Hospitals-Case Series Descriptive Study", Journal of the Korean Society of Emergency Medicine, Vol. 22, No. 5, pp. 531-535 (2011).
  15. J. Y. Lee and K. W. Lee, "Clinical Characteristics in Geriatric Trauma Victims between a Metropolitan City and Rural Areas", Journal of the Korean Society of Emergency Medicine, Vol. 19, No. 5, pp. 506-512 (2008).
  16. I. S. Yoo, K. H. Lee, T. Heo, H. W. Yoo, and J. S. Park, A Basic Study on Enhancement of Transfer Information-Transfer Appropriateness Analysis, National Emergency Medical Center, Korea (2011).
  17. Korea Institute for Health and Social Affairs, National Health Insurance, Korea Health Panel, Available From: http://www.khp.re.kr/. (accessed April 10, 2014).
  18. Korea Institute for Health and Social Affairs, National Health Insurance, 2011 Korea Health Panel: Basic Analysis Report (1), Policy Report 2013, Korea (2013).
  19. Y. Tokuda, T Abe, S. Ishimatsu and S. Hinohara, "Ambulance Transport of the Oldest Old in Tokyo: A Population-Based Study", J Epidemiol, Vol. 20, No. 6, pp. 468-472 (2010). https://doi.org/10.2188/jea.JE20090210
  20. J. A. Lowthian, P. A. Cameron, J. U. Stoelwinder, A. Curtis, A. Currell, M. W. Cooke and J. J. McNeil, "increasing Utilisation of Emergency Ambulances," Australian Health Review, Vol. 35, No. 1, pp. 63-69 (2011). https://doi.org/10.1071/AH09866
  21. M. N. Shah, C. Glushak, T. G. Karrison, R. Mulliken, J. Walter, P. Friedmann, D. C. Hayley and M. H. Chin, "Predictors of Emergency Medical Service Utilization by Elders", Academic Emergency Medicine, Vol. 10, No. 1, pp. 52-58 (2003). https://doi.org/10.1111/j.1553-2712.2003.tb01976.x
  22. M. N. Shah, J. J. Bazarian, E. B. Lerner, R. J. Fairbanks, W. H. Barker, P. Auiner and B. Friedman, "The Epidemiology of Emergency Medical Services Use by Older Alders: An Analysis of the National Hospital Ambulatory Medical Care Study", Academic Emergency Medicine, Vol. 14, No. 5, pp. 441-447 (2007). https://doi.org/10.1111/j.1553-2712.2007.tb01804.x
  23. J. E. Svenson, "Patterns of Use of Emergency Medical Transport: A Population-based Study", American Journal of Emergency Medicine, Vol. 18, No. 2, pp. 130-134 (2000). https://doi.org/10.1016/S0735-6757(00)90002-0
  24. C. Kawakami, K. Ohshige, K. Kubota and O. Tochikubo, "Influence of Socioeconomic Factors on Medically Unnecessary Ambulance Calls", BMC Health Services Research, Vol. 7, No. 1, pp. 120, (2007). https://doi.org/10.1186/1472-6963-7-120
  25. Z. F. Meisel, J. M. Pines, S. Polsky, J. P. Metlay, M. D. Neuman and C. C. Branas, "Variations in Ambulance Use in the United States: The Role of Health Insurance", Academic Emergency Medicine, Vol. 18, No. 10, pp. 1036-1044 (2011). https://doi.org/10.1111/j.1553-2712.2011.01163.x
  26. C. W. Burt, L. F. McCaig and R. H. Valverde, "Analysis of Ambulance Transports and Diversions Among US Emergency Departments", Ann. Emerg. Med., Vol. 47, No. 4, pp. 317-326 (2006). https://doi.org/10.1016/j.annemergmed.2005.12.001
  27. J. Y. Jung and H. J. Hwang, "A Study of Revitalization of the Emergency Medical Services for a Aged Societybased on Possible Solutions to Improve Early Response System for Geriatric Emergency Patients", J. of Korean Institute of Fire Sci. & Eng., Vol. 22, No. 5, pp. 99-104 (2008).