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J Korean Soc Emerg Med > Volume 29(2); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(2): 144-151.
응급실 퇴실배치와 한국형 응급환자 분류체계를 통한 응급여부, 내원수단의 관계
왕일재1, 조석주1, 염석란1, 배병관1, 조영모1, 이강호2, 김미정3, 황성연4, 박재성5
1부산대학교병원 응급의학과
2양산부산대학교병원 응급의학과
3성덕대학교 응급구조과
4성균관대학교 의과대학 삼성창원병원 응급의학과
5동주대학교 응급구조과
Relationship between emergency department disposition, level of emergency base on Korean Triage and Acuity Scale, visit mode
Il Jae Wang1, Suck Ju Cho1, Seok Ran Yeom1, Byung Kwan Bae1, Young Mo Cho1, Kang Ho Lee2, Mi Jung Kim3, Seong Yeon Hwang4, Jae Seong Park5
1Department of Emergency Medicine, Pusan National University Hospital, Pusan, Korea
2Department of Emergency Medicine, Pusan National University Yangsan Hospital, Pusan, Korea
3Department of Emergency Medical Technology, Sungduk University, Youngcheon, Korea
4Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
5Department of Emergency Medical Technology, Dongju University, Pusan, Korea
Correspondence  Suck Ju Cho ,Tel: 051-240-7503, Fax: 051-253-6472, Email: csjmedigate@naver.com,
Received: December 12, 2017; Revised: December 13, 2017   Accepted: January 2, 2018.  Published online: April 30, 2018.
ABSTRACT
Objective:
The policy to judge the level of emergency (emergent vs non-emergent) based on Korean Triage and Acuity Scale (KTAS) has been introduced by government to control the flow of emergency patients. The purpose of this study is to identify the variables expected to affect the disposition and to compare the relative importance of the variables. And we also evaluate the validity of the policy to judge the level of emergency based on KTAS.
Method:
We enrolled a total of 29,865 patients who visited a Wide Regional Emergency Center in Busan from Jan 2016 to Dec 2016. Data of those patients were extracted from National Emergency Department Information System (NEDIS) and analysed retrospectively. We determined disposition as the outcome variable. We evaluated the relationship between disposition and visit time, visit mode (firehouse ambulance, inter-facility transfer and self-transport), level of emergency based on KTAS, cause of morbidity. And we also evaluated general and conditional dominances of those variables to compare their relative importance each other.
Results:
The disposition of the patients was discharge to home (53.5%), general ward admission (30.3%), intensive care unit admission (11.6%), and inter-facility transfer (4.8%). In the univariate analysis, age, gender, visit time, visit mode, cause of morbidity, KTAS level had a significant effect on the disposition. All variables that had a significant effect on univariate analysis also had a significant effect on disposition in multivariate analysis. As a result of dominance analysis, visit mode was the most important variable in both general dominance and conditional dominance. However, if KTAS was devided into 5 levels, it was the most important variable.
Conclusion:
Level of emergency based on KTAS was significantly effective on patient disposition, however it was relatively less important compared to the visit mode. If the visit mode is reflected in the triage system, triage accuracy is expected to be improved. And it also can be a good option to construct triage system based on 5 level KTAS.
Key words: Triage; Emergency medical services; Emergency department; Disposition
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