국민건강보험공단 데이터베이스를 이용한 국내 이비인후과 수술 전 검사 현황 분석
Analysis of Routine ENT Preoperative Assessment Using Korean National Health Insurance Database
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Background and Objectives Preoperative assessment is one of the most important fields insurgery and anesthesia as it can reduce morbidity and mortality from surgery and detect abnormalfindings not clinically observed through preoperative examination. However, excessivenon-vital preoperative routine tests have been criticized. The aim of the study is to investigatethe current use of elective preoperative evaluations using otorhinolaryngologic surgerycovering patients of all ages with various levels of difficulty. Subjects and Method Using the Korean National Health Insurance Service National SampleCohort data, we investigated 98890 subjects who underwent otorhinolaryngologic surgeryduring the year 2018. We evaluated sociodemographic characteristics, clinical characteristics,medical institutions, and operation characteristics of the subjects and analyzed in detail theirroutine blood and urine test items, sonographic exams and pulmonary function tests. Results There were differences in the implementation of preoperative blood and urine tests,sonographic exams and pulmonary function tests according to sociodemographic characteristics,types and locations of medical institutions. Old age, low socioeconomic status, comorbidcondition, high Charlson’s Comorbidity Index, tertiary hospital were the factors that increasedpreoperative evaluation tests. Conclusion Appropriate preoperative evaluation is needed for predicting and preparing forthe possibility of treatment complications as well as improving treatment quality while reducingcosts for perioperative management.
Abstract
Background and Objectives Preoperative assessment is one of the most important fields insurgery and anesthesia as it can reduce morbidity and mortality from surgery and detect abnormalfindings not clinically observed through preoperative examination. However, excessivenon-vital preoperative routine tests have been criticized. The aim of the study is to investigatethe current use of elective preoperative evaluations using otorhinolaryngologic surgerycovering patients of all ages with various levels of difficulty. Subjects and Method Using the Korean National Health Insurance Service National SampleCohort data, we investigated 98890 subjects who underwent otorhinolaryngologic surgeryduring the year 2018. We evaluated sociodemographic characteristics, clinical characteristics,medical institutions, and operation characteristics of the subjects and analyzed in detail theirroutine blood and urine test items, sonographic exams and pulmonary function tests. Results There were differences in the implementation of preoperative blood and urine tests,sonographic exams and pulmonary function tests according to sociodemographic characteristics,types and locations of medical institutions. Old age, low socioeconomic status, comorbidcondition, high Charlson’s Comorbidity Index, tertiary hospital were the factors that increasedpreoperative evaluation tests. Conclusion Appropriate preoperative evaluation is needed for predicting and preparing forthe possibility of treatment complications as well as improving treatment quality while reducingcosts for perioperative management.
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