환자안전사고에 의한 손상환자의 병원내 사망 관련 요인 : 2013-2017 퇴원손상심층조사자료 활용

Factors Related to In-Hospital Death of Injured Patients by Patient Safety Accident : Using 2013-2017 Korean National Hospital Discharge In-depth Injury Survey

  • 김상미 (전주대학교 보건관리학과) ;
  • 이현숙 (국립공주대학교 보건행정학과)
  • Kim, Sang Mi (Department of Health Management, Jeonju University) ;
  • Lee, Hyun Sook (Department. of Health Administration, Kongju National University)
  • 투고 : 2020.11.29
  • 심사 : 2021.02.10
  • 발행 : 2021.03.31

초록

This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

키워드

참고문헌

  1. WHO. Conceptual Framework for the International Classification for Patient Safety. Final Technical Report January 2009.
  2. Kim SK, Lee SI. A Study on the Establishment of Patient Safety System. National Evidence-based Healthcare Collaborating Agency 2015.
  3. WHO, The World Health Report 2002. [cited 2020 Nov 1] https://www.who.int/whr/2002/en/whr02_en.pdf
  4. National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Healthcare. Washington, DC: The National Academies Press 2015:311-314.
  5. National Patient Safety Incident Reports. [cited 2020 Nov 3] Available from https://improvement.nhs.uk/resources/national-quarterly-data-patient-safety-incident-reports/
  6. Lee JH, Lee SI. Patient Safety: The Concept and General Approach. J Korean Society of Quality Assurance in Health Care 2009;15(1):9-18.
  7. Lee SI. 2012 Hospital Medical Policy Spring Symposium
  8. Korea Patient Safety Reporting & Learning System. [cited 2020 Nov 6] Available from https://www.kops.or.kr/portal/pag/view/kops/kopsGuide.do
  9. Lee SI. Development of Institutional Mechanism for Improving Patient Safety in Korea. Korea Centers for Disease Control and Prevention. 2013
  10. Lee SI. Policy Measures to Improve the Quality of Medical Care. Health and Welfare Policy Institute. 2017:229-261.
  11. Starfield B. Is US Health Really the Best in the World? JAMA 2000;284(4):483-485. https://doi.org/10.1001/jama.284.4.483
  12. Ministry of Health and Welfare. The 1st Comprehensive Patient Safety Plan. 2018.13. 13. WHO-ICECI Coordination and Maintenance Group. International Classification of External Causes of Injury(ICECI). Amsterdam: Consumer Safety Institute; July 2004.
  13. Vincent C. Patient Safety. 2nd ed. West Sussex: Wiley-Blackwell 2010.
  14. Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson Comorbidity Index Predicted in-hospital Mortality. J Clin Epidemiol. 2004 Dec;57(12):1288-1294. https://doi.org/10.1016/j.jclinepi.2004.03.012
  15. Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, Saunders LD, Beck CA, Feasby TE, Ghali WA. Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data. Med Care. 2005 Nov; 43(11):1130-1139. https://doi.org/10.1097/01.mlr.0000182534.19832.83
  16. Korea Centers for Disease Control and Prevention. Guidelines for Use of Raw Data for Korean National Hospital Discharge In-depth Injury Survey in 2015. 2015.
  17. Korea Institute for Healthcare Accreditation. 2017 Patient Safety Statistical Yearbook. [cited 2020 Oct 13]. Available from https://www.kops.or.kr/portal/board/stat/boardList.do
  18. Kang MU, Kim JK, Lim YS, Kim JJ, Hyun SY, Yang HJ, et al. Value of Voluntary Intranetbased Medical Error Reporting System. J Korean Emergency Medical Association 2010;21(1):110-118.
  19. Baines RJ, Langelaan M, de Bruijne MC, Wagner C. Is Researching Adverse Events in Hospital Deaths a Good Way to Describe Patient Safety in Hospitals: a Retrospective Patient Record Review Study. BMJ Open. 2015 Jul 9;5(7):e007380. https://doi.org/10.1136/bmjopen-2014-007380
  20. Haukland EC, Mevik K, von Plessen C, Nieder C, Vonen B. Contribution of Adverse Events to Death of Hospitalised Patients. BMJ Open Qual. 2019 Feb 13;8(1):e000377. https://doi.org/10.1136/bmjoq-2018-000377
  21. OECD. OECD Reviews of Health Care Quality: Korea 2012.
  22. Rafter N, Hickey A, Condell S, Conroy R, O'Connor P, Vaughan D, Williams D. Adverse Events in Healthcare: Learning from Mistakes. QJM. 2015 Apr;108(4):273-277. https://doi.org/10.1093/qjmed/hcu145
  23. Kavanagh KT, Saman DM, Bartel R, Westerman K. Estimating Hospital-Related Deaths Due to Medical Error: A Perspective From Patient Advocates. J Patient Saf. 2017 Mar;13(1):1-5. https://doi.org/10.1097/PTS.0000000000000364
  24. Ock M, Lee SI, Kim JH, Lee JH, Lee JY, Jo MW, et al. What Should We Consider for Establishing a National Patient Safety Reporting System?. J Health Technology Assessment. 2015;3(1):4-16. https://doi.org/10.34161/johta.2015.3.1.002
  25. Kang HJ. Patient Safety Indicators in Korea and Ways for Their Improvement. Health and Welfare Forum 2016;10:17-30.