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J Korean Soc Emerg Med > Volume 35(2); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(2): 181-191.
지역응급의료센터의 격리병상 과밀화 지표분석: 코로나-19 대유행 시기의 경기도 소재 지역응급의료센터 사례를 중심으로
이산 , 유진현 , 신소미 , 노현웅 , 김윤준 , 곽동훈 , 김형수 , 최익창 , 서민구
광명성애병원 응급의학과
Analysis of overcrowding indices of isolation beds at a single regional emergency department in the COVID-19 pandemic era
San Lee , Jin Hyun Yoo , So Mi Shin , Hyun Woong Noh , Yun Jun Kim , Dong Hun Kwak , Hyung Soo Kim , Ik Chang Choi , Min Gu Seo
Department of Emergency Medicine, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
Correspondence  Jin Hyun Yoo ,Tel: 02-2680-7117, Fax: 02-2680-7557, Email: powermountain2@gmail.com,
Received: June 16, 2023; Revised: September 13, 2023   Accepted: September 15, 2023.  Published online: April 30, 2024.
ABSTRACT
Objective:
Emergency department (ED) overcrowding is a global issue that negatively impacts the clinical outcome. Through the coronavirus disease 2019 (COVID-19) pandemic era, overcrowding of ED isolated territory (isolation bed) was aggravated. This study analyzed overcrowding indices of ED isolation beds during the COVID-19 pandemic.
Method:
This study was a single-center, retrospective, observational study. The study analyzed 34,925 patients who visited the ED during the COVID-19 pandemic from April 2021 to August 2022. Patients who were treated in isolation beds and regular beds were compared. Among the patients using isolation beds, patients who stayed longer than 720 minutes were also classified and analyzed.
Results:
During the analysis period, 4,479 and 34,943 patients were treated in the ED isolation bed and ED regular bed, respectively. The overcrowding indices (general ward admission rate, intensive care unit admission rate, ED-length of stay, transfer rate, mortality rate, prolonged ED stay patient ratio) of the isolation beds were significantly higher than those of the ED regular bed (P<0.05). The prolonged ED stay-patient ratio of isolation beds and regular beds was affected by the number of COVID-19 patients (regular bed, r=0.617 and P=0.01; isolation bed, r=0.525 and P=0.03). The average ED-length of stay of isolation beds was longer than that of the ED regular beds. One hundred and forty-five patients were classified as prolonged ED stay patients. Their time from the decision point to the discharge point comprised a higher rate with an average of 76.52%.
Conclusion:
ED isolation beds are more vulnerable to infectious disease outbreaks. A proper medical policy and arrangement management system that can flexibly deal with disaster emergencies are required
Key words: Crowding; COVID-19; Length of stay; Patient isolation; Pandemics; Disasters; Public health administration
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