서울시 119 구급대의 병원전 응급처치 적절성 평가 (Evaluation of the Appropriateness ofPrehospital Emergency Care by 119Rescue Services in Seoul MetropolitanArea)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 19권 / 3호 / 233 ~ 244페이지
· 저자명 : 정중식, 홍기정, 신상도, 서길준, 송경준

초록

Purpose: The purpose of this study was to evaluate the
appropriateness of prehospital emergency care by 119 rescue
services in Seoul.
Methods: We enrolled all patients who used 119 rescue
services in Seoul between January and Sepember 2006
and analyzed the 119 ambulance patient care record databases.
Major emergencies were defined and categorized
into four groups: cardiopulmonary complaint (CP), neurologic
complaint (NR), cardiorespiratory arrest (CA) and
major trauma (MT). Interventions provided by emergency
medical technicians were scored as 2:essential, 1:optional
and 0:unnecessary in each category of major emergency.
We summed scores of provided interventions per patient
and graded them into four levels for conducting the appropriateness
review. Multivariate logistic regression analysis
was performed to determine the relationship of risk factors
to the appropriateness of intervention.
Results: Total number of cases was 171,112 of which 36,065 were major emergencies. The proportion of “very
low” level appropriate was 40.1% for CP (N=11,522).
49.3% for NR (N=15,239), 14.5% for CA (N=1,591), and
32.7% for MT (N=7,713). The proportion of “high” level was
less than 3% except for CA(11.3%). Variables affecting the
“moderate” or “high” level of appropriateness of prehospital
emergency care, as determined by multivariate logistic
regression analysis, were age ≥65(OR: 1.425, 95% CI:
1.337-1.520), female gender (OR: 0.880, 95% CI: 0.828-
0.935), and type of complaint in the order CP (OR: 0.181,
95% CI: 0.161-0.204), NR (OR: 0.184, 95% CI: 0.164-
0.207), and MT (OR: 0.202, 95% CI: 0.178-0.229).
Conclusion: The prehospital emergency care of 119 rescue
services in Seoul was frequently inappropriate and was
influenced by patient’s age, gender and chief complaints.

영어초록

Purpose: The purpose of this study was to evaluate the
appropriateness of prehospital emergency care by 119 rescue
services in Seoul.
Methods: We enrolled all patients who used 119 rescue
services in Seoul between January and Sepember 2006
and analyzed the 119 ambulance patient care record databases.
Major emergencies were defined and categorized
into four groups: cardiopulmonary complaint (CP), neurologic
complaint (NR), cardiorespiratory arrest (CA) and
major trauma (MT). Interventions provided by emergency
medical technicians were scored as 2:essential, 1:optional
and 0:unnecessary in each category of major emergency.
We summed scores of provided interventions per patient
and graded them into four levels for conducting the appropriateness
review. Multivariate logistic regression analysis
was performed to determine the relationship of risk factors
to the appropriateness of intervention.
Results: Total number of cases was 171,112 of which 36,065 were major emergencies. The proportion of “very
low” level appropriate was 40.1% for CP (N=11,522).
49.3% for NR (N=15,239), 14.5% for CA (N=1,591), and
32.7% for MT (N=7,713). The proportion of “high” level was
less than 3% except for CA(11.3%). Variables affecting the
“moderate” or “high” level of appropriateness of prehospital
emergency care, as determined by multivariate logistic
regression analysis, were age ≥65(OR: 1.425, 95% CI:
1.337-1.520), female gender (OR: 0.880, 95% CI: 0.828-
0.935), and type of complaint in the order CP (OR: 0.181,
95% CI: 0.161-0.204), NR (OR: 0.184, 95% CI: 0.164-
0.207), and MT (OR: 0.202, 95% CI: 0.178-0.229).
Conclusion: The prehospital emergency care of 119 rescue
services in Seoul was frequently inappropriate and was
influenced by patient’s age, gender and chief complaints.

참고자료

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