융합정보논문지 (Journal of Convergence for Information Technology)

중소기업융합학회 (Convergence Society for SMB)
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외래의료 민감 질환으로 응급실을 내원한 환자의 특성 분석: 의료전달체계 중심으로

Analysis of the Characteristics of Ambulatory Care Sensitive Conditions in Patients Visiting the Emergency Departments: Focused on Health-care Delivery System

  • 허영진 (국립중앙의료원 중앙응급의료센터) ;
  • 김지연 (국립중앙의료원 중앙응급의료센터) ;
  • 이명화 (국립중앙의료원 중앙응급의료센터) ;
  • 이성민 (전남대학교병원 응급의학과) ;
  • 오미라 (국립중앙의료원 중앙응급의료센터)
  • Huh, Young-Jin (National Emergency Medical Center, National Medical Center) ;
  • Kim, Ji-Yeon (National Emergency Medical Center, National Medical Center) ;
  • Lee, Myoung-Hwa (National Emergency Medical Center, National Medical Center) ;
  • Lee, Sung-Min (Department of Emergency Medicine, Chonnam National University Hospital) ;
  • Oh, Mi-Ra (National Emergency Medical Center, National Medical Center)
  • 투고 : 2020.09.03
  • 심사 : 2020.10.20
  • 발행 : 2020.10.28
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초록

본 연구는 외래의료 민감 질환(Ambulatory Care Sensitive Conditions, ACSCs)으로 응급실에 내원한 환자들의 특성을 연령(성인 19-64세, 노인 65세 이상)으로 구분하여 그 차이를 비교 분석하였다. 2018년 1월 1일부터 12월 31일까지의 국가응급진료정보망 자료를 이용하여 응급의료기관 종별과 ACSCs의 비율, 응급실 재실시간, 입원일수, 입원율을 살펴보았다. 응급의료기관 종별에서는 지역응급의료센터의 비율이 높았고(P<0.001), ACSCs의 질환 비율에서 성인은 위장염 31.7%와 노인은 폐렴 48.2%로 높게 나타났다(P<0.001). 응급실 재실시간은 울혈성심부전과 당뇨를 제외한 모든 질환에서 노인이 길게 나타났고(P<0.001), 입원일수는 ACSCs 모든 질환에서 노인이 유의하게 길게 나타났으며(P<0.05), 입원율은 당뇨를 제외한 모든 질환에서 노인의 비율이 유의하게 높았다(P<0.01). 이와 같이 ACSCs로 인한 응급실 이용을 파악하여 외래 중심으로 치료를 유도할 수 있도록 의료정책을 강화해야 할 것이다.

This study analyzed, the characteristics of ambulatory care sensitive conditions(ACSCs) in patients visiting emergency departments(EDs) and compared characteristics according to two age groups (adults aged 19-64 years and, elderly people aged ≥65 years). By accessing data from the National Emergency Department Information System(NEDIS) from January 1 to December 31, 2018, we examined the proportions of different ED types and ACSCs, length of stay(LOS) in the ED, LOS hospital, and hospital admission rates. Regarding the types of EDs, we found that the proportion of local emergency medical centers was high(P<0.001). Regarding the rates of different ACSCs, 31.7% of adults were treated for gastroenteritis, a high proportion of the elderly people(48.2%) were diagnosed with and treated for pneumonia(P<0.001). The LOS in the ED was longer in elderly people for all diseases categories, except for congestive heart failure and diabetes(P<0.001). The LOS in the hospital was also significantly longer in elderly people for all ACSCs(P<0.05), and the admission rate was significantly higher in elderly people for all diseases, except for diabetes(P<0.01). Thus, analyzing the ED visits made by patients with ACSCs will need to strengthen the health-care policy to induce treatment centered on outpatient.

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참고문헌

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