구급차 동승을 통한 지역주민의 응급의료체계 이용의 적절성 및 성향 조사

Title
구급차 동승을 통한 지역주민의 응급의료체계 이용의 적절성 및 성향 조사
Other Titles
Appropriateness of the use of Emergency Medical Services and Propensities Toward Choice by Local Residents of Hospitals
Author(s)
도병수이삼범이한국[이한국]
Keywords
Emergency medical services; Transportation of patients; Appropriateness
Issue Date
201010
Publisher
대한응급의학회
Citation
대한응급의학회지, v.21, no.5, pp.525 - 530
Abstract
Purpose: Inappropriate use or misuse of emergency medical services (EMS) is a potential waste of resources and a possible diversion of needed service from another patient in need. One of the most serious consequences of inappropriate use of EMS is emergency department crowding. The purpose of this study was to evaluate the appropriateness of EMS use and the propensity of local residents in Daegu to choose particular hospitals. Methods: We obtained study data from Jan. to Feb. 2009using a prospective survey of patients or their companies that had used EMS. The survey was done by a senior emergency physician who rode in an ambulance with 119crew members during on-scene assessments and en route to the hospital. The severity of illness/injury was evaluated using the START system/CRAMS scale. We analyzed the appropriateness of EMS use and hospital transport in relation to the severity of the patients problem. We also identified factors that directly influence choice of hospitals. Results: Forty-six cases (36.8%) chose an inappropriate hospital. In 89 cases (71.2%), choice of hospital was done by the patient or his guardian. The most common factor that directly influenced hospital choice was the hospital the patients identified with (50%). Appropriateness of transport to the hospital correlated with problem severity evaluated by the EMS team and by trauma patients (p<0.05). Transport to a higher level hospital (39%) was selected about ten fold more often than transport to a lower level hospital (4%). Conclusion: The appropriateness of local EMS use should be improved with respect to many factors. Local residents have a propensity to choose a large or university hospital for a variety of reasons. Local residents should be continuously educated for appropriative EMS use.
URI
http://hdl.handle.net/YU.REPOSITORY/23448
ISSN
1226-4334
Appears in Collections:
의과대학 > 응급의학교실 > Articles
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