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Trend of Emergency Department Visits for Elderly Patients with Chronic Diseases : 2014-2019

만성질환을 동반한 노인 응급환자 추이: 2014-2019

  • Lee, Myoung-Hwa (National Emergency Medical Center, National Medical Center) ;
  • Kim, Ji-Yeon (National Emergency Medical Center, National Medical Center) ;
  • Huh, Young-Jin (National Emergency Medical Center, National Medical Center) ;
  • Oh, Mi-Ra (National Emergency Medical Center, National Medical Center)
  • 이명화 (국립중앙의료원 중앙응급의료센터) ;
  • 김지연 (국립중앙의료원 중앙응급의료센터) ;
  • 허영진 (국립중앙의료원 중앙응급의료센터) ;
  • 오미라 (국립중앙의료원 중앙응급의료센터)
  • Received : 2020.11.09
  • Accepted : 2021.01.20
  • Published : 2021.01.28

Abstract

The purpose of this study was to determine the change trend of emergency department visits among elderly patients with chronic diseases. Using the National Emergency Department Information System data, from January 1, 2014 to December 31, 2019, the selected patient data were evaluated for the emergency department discharge main diagnosis codes for eight chronic diseases. The incidence of elderly chronic diseases, emergency department visits, and admission rates were analyzed. Since 2014, there has been a consistent increase in the number of elderly patients visiting the emergency department, especially among those aged over 85 years. The number of emergency department visits among the elderly chronically ill patients also increased, with a significant increase in ischemic heart disease and arthrosis cases. Furthermore, there was a significant difference in the number of chronically ill patients in each year from 2014-2019 (P<0.001). With respect to the trend of admission rates to the emergency department by chronic disease, most diseases showed an increasing trend (P<0.001). however, hyperlipidemia showed a continuous decreasing trend in all age groups since 2014 (P<0.001). Among the elderly chronically ill patients, a greater increase in the admission rate following emergency department visits was noted in those over 85 years of age, with a significant difference in all diseases, except for hyperlipidemia, hypertension, and tuberculosis (P<0.001). As the aging population grows, the emergency department admission rates among the elderly chronically ill patients will rise rapidly. This could create issues with respect to the use and consumption of emergency medical resources. Hence, it is necessary to manage chronic diseases effectively in the elderly.

본 논문은 만성질환으로 응급실에 내원한 노인 환자의 응급의료 이용 변화 추이를 알아보고자 하였다. 2014년 1월 1일부터 2019년 12월 31일까지의 국가응급진료정보망 자료에서 응급실 퇴실 주 진단 상병코드가 8개 만성질환에 해당하는 환자를 선택하여 응급실 이용 현황 및 응급실 내원과 입원의 변화 추이를 살펴보았다. 2014년을 기준으로 만성질환으로 응급실을 내원한 노인 환자는 지속 증가하였고, 특히 85세 이상의 환자가 급격히 증가하였다. 만성질환별 응급실 내원 비율 변화추이에서는 대부분 질환에서 증가세를 보였고(P<0.001), 그 중 허혈성심장질환, 관절병증에서 높은 증가율을 보였으나 고지혈증은 전 연령에서 감소세를 보였다(P<0.001). 응급실 입원율 변화 추이에서는 고지혈증, 고혈압, 결핵을 제외한 만성질환에서 지속적으로 증가세를 보였다(P<0.001). 만성질환을 가진 노인 환자의 응급실 내원 및 입원율의 지속적인 증가는 응급의료자원의 점유 및 의료 소비량 증가 문제를 가속시킬 수 있는 원인으로 작용할 수 있으므로 적절한 만성질환 관리가 필요하다.

Keywords

References

  1. Korean Statistical Information Service. (2019). Future population estimation. Daejeon : Statistics Korea. http://kosis.kr
  2. S. K. Nam & O. S. Shin. (2011). A study on the influence factors on quality of life of elderly with chronic disease. Journal of Welfare for the Aged Institute, 53(2), 239-59.
  3. Chronic disease prevention and management. (2013). National Conference & State Legislatures. 1-2. https://www.ncsl.org
  4. H. M. Lee & K. H. Cho. (2007). Use of medical resources by the elderly population in emergency department. Journal of the Korean Geriatrics Society, 11(3), 139-44.
  5. D. C. Roberts, M. P. McKay & A. Shaffer. (2008). Increasing rates of emergency department visits for elderly patients in the Unites States 1993 to 2003. Annals of emergency medicine, 51(6), 769-74. DOI : 10.1016/j.annemergmed.2007.09.011
  6. E. M. Ham et al. (2017). Analysis of epidemiologic characteristics between patients visited from residential aged care facilities and elderly patients visited from home admitted to the emergency department with disease. Journal of The Korean Society of Emergency Medicine, 28(1), 87-96.
  7. S. J. Wang. (2003). Introduction of geriatric emergency medicine. Journal of the Korean Geriatrics Society, 7(1), 1-13.
  8. M. S. P. Choe et al. (2003). Clinical analysis of frequent attenders of emergency department. Journal of The Korean Society of Emergency Medicine, 14(5), 60-8.
  9. T. G. Shin, J. W. Song, H. G. Song & C. K. Hong. (2011). Characteristics of frequent users of emergency department. Journal of The Korean Society of Emergency Medicine, 22(1), 86-92.
  10. L. Bernice. (1974). Age Groups in American Society and the Rise of the Young-Old. Annals of the American Academy of Political and Social Science, 415(1), 187-198. DOI : 10.1177/000271627441500114
  11. K. R. Kim et al. (2016). Policy Support for the Last Phase of Life for Oldest-Older People in a Post-Aged Korea. Korea Institute for Health and Social Affairs. 31-32. http://www.kihasa.re.kr
  12. E. H. Roh & S. C. Park. (2020). Association between clustering of lifestyle and chronic disease using healthcare big data. Journal of Health Informatics and Statistics, 45(2), 113-23. DOI : 10.21032/jhis.2020.45.2.113
  13. X. Tong et al. (2019). The Burden of Cerebrovascular Disease in the United States. Preventing Chronic Disease, 16(180411). DOI : 10.5888/pcd16.180411
  14. A. Talwalkar & S. Uddin. (2015). Trends in Emergency Department Visits for Ischemic Stroke and Transient Ischemic Attack: United States, 2001-2011. NCHS Data Brief, Mar(194), 1-8.
  15. M. Sadik et al. (2014). Attributes of cancer patients admitted to the emergency department in one year. World Journal of Emergency Medicine, 5(2), 85-90. DOI : 10.5847/wjem.j.issn.1920-8642.2014.02.001
  16. H. H. Jin, S. B. Lee, B. S. Do & B. Y. Chun. (2007). Prehospital Status of the Patients with Ischemic Chest Pain before Admitting in the Emergency Department. Yeungnam University Journal of Medicine, 24(1), 41-54. DOI : 10.12701/yujm.2007.24.1.41
  17. K. S. Cho. (2017). Tuberculosis Control in the Republic of Korea. Health and Social Welfare Review, 37(4), 179-212. https://doi.org/10.15709/HSWR.2017.37.4.179
  18. Y. S. Seo, J. H. Park & J. H. Lim. (2014). Factors Affecting Regular Medical Services Utilization of Chronic Disease Patients -Focusing on the Hypertension, Diabetes Mellitus, Hyperlipidemia-. Korean Journal of Health Education and Promotion, 31(3), 27-37. DOI : 10.14367/kjhep.2014.31.3.27
  19. D. W. Ballard et al. (2010). Validation of an algorithm for categorizing the severity of hospital emergency department visits. Medical Care, 48, 58-63. DOI : 10.1097/MLR.0b013e3181bd49ad
  20. S. Miller. (2012). The effect of insurance on emergency room visits: An analysis of the 2006 Massachusetts health reform. Journal of Public Economics, 96(11-12), 893-908. DOI : 10.1016/j.jpubeco.2012.07.004
  21. A. Bamezai, G. Melnick & A. Nawathe. (2005). The cost of an emergency department visit and its relationship to emergency department volume. Annals of emergency medicine, 45(5), 483-90. DOI : 10.1016/j.annemergmed.2004.08.029
  22. Chronic disease status and issue. (2019). Korea Centers for Disease Control & Prevention. 6-58. http://www.cdc.go.kr
  23. H. S. Kim, B. N. Yoo & E. H. Lee. (2018). Evaluation of the national chronic diseases management policy: Performance and future directions. Public Health Affairs, 2(1), 105-20. DOI : 10.29339/pha.2.1.105
  24. J. O. Han, K. H. Kang & J. Yim. (2017). The usual source of healthcare and frequent visits to emergency departments. The Korean Journal of Emergency Medical Services, 21(3), 97-107. https://doi.org/10.14408/KJEMS.2017.21.3.097