Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service

의료 기관 구분에 따른 중독 환자의 사망률 - 건강보험심사평가원 자료 기반

  • Kim, Soyoung (Department of Emergency Medicine, Anyang Sam Hospital) ;
  • Choi, Sangchun (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Kim, Hyuk-Hoon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Yang, Hee Won (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Yoon, Sangkyu (Department of Emergency Medicine, Anyang Sam Hospital)
  • 김소영 (안양샘병원 응급의학과) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 김혁훈 (아주대학교 의과대학 응급의학교실) ;
  • 양희원 (아주대학교 의과대학 응급의학교실) ;
  • 윤상규 (안양샘병원 응급의학과)
  • Received : 2019.04.12
  • Accepted : 2019.05.25
  • Published : 2019.06.30
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Abstract

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

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