Comparison of emergency department utilization between the emergency medical center and local emergency medical agency for patients with a critical illness code

Hong, Jiae; Ko, Eunsil; Pak, Yun-Suk; Jeong, Jinwoo; Chae, Bora; Kim, Won Young

J Korean Soc Emerg Med > Volume 35(4); 2024 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2024;35(4): 321-329.

중증상병코드환자의 응급실 이용현황에 대한 센터급 응급의료기관과 지역응급의료기관의 비교 분석

홍지애¹

¹울산대학교 의과대학 서울아산병원 응급의학과
²국립중앙의료원 중앙응급의료센터
³동아대학교 의과대학 응급의학교실

Comparison of emergency department utilization between the emergency medical center and local emergency medical agency for patients with a critical illness code

¹Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
²National Emergency Medical Center, National Medical Center, Seoul, Korea
³Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea

Correspondence

Won Young Kim ,Tel: 02-3010-3350, Fax: 02-3010-3360, Email: wonpia73@naver.com,

Received: August 24, 2023; Revised: September 18, 2023 Accepted: September 19, 2023. Published online: August 30, 2024.

ABSTRACT

Objective:
Emergency medical system reform is an important part of the 4th Emergency Medical Care 5-year plan in Korea, published in 2023. However, little is known about the current emergency department (ED) utilization status of local emergency medical agencies (EMAs). We sought to compare the ED utilization code between the emergency medical centers (EMCs) (n=58) and the local EMAs (n=152) based on parameters such as the admission rate or transfer rate in patients with a critical illness.
Method:
Consecutive emergency patients registered on the National Emergency Department Information System from January 2022 to December 2022 were included in this study and their records were analyzed. The study included critically ill patients who were defined as having a critical illness code.
Results:
Among 590,878 (EMC of 450,007; local EMA of 140,871) critical illness code patients, the admission rate was 76.2% for EMCs and 52.9% for local EMAs. Of the critical illness code patients who visited local EMAs, 89.4% were Korean Triage and Acuity Scale (KTAS) grade 3-5 patients. The hospitalization volume of critical illness code patients in the local EMAs was 74,571, mostly major trauma (47.5%) and ischemic stroke (11.5%). If KTAS grade 1 or 2 patients could not be transferred to the local EMAs, the EMCs covered up to 14,989 ED patients and 74,571 admitted patients additionally.
Conclusion:
If the local EMAs maintain their current roles in the areas of major trauma and ischemic stroke, and take charge of the admission of patients with critical illness codes transferred from the EMC after emergency treatment, then the local EMAs can still maintain their functions even after the proposed emergency medical system reform.

Key words: Emergency medicine; Emergency service; Hospitals; Critical illness