Analysis of the Impact of the Coronavirus Disease Epidemic on the Emergency Medical System in South Korea Using the Korean Triage and Acuity Scale
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Purpose: Severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19), has spreadworldwide. Global health systems, including emergency medical systems, are suffering from a lack of medical resources. Using amethod for classifying patients visiting the emergency department (ED), we aimed to investigate trends in emergency medicalsystem usage during the COVID-19 epidemic in Korea. Materials and Methods: This retrospective observational study included patients who visited emergency medical institutionsregistered with the National Emergency Department Information System database from January 1, 2017 to May 31, 2020. The primaryoutcome was identification of changes in the distribution of patients visiting the ED according to the type of emergencymedical institution. The secondary outcome was a detailed comparison of Korean Triage and Acuity Scale (KTAS) levels and patientdistributions before and during the infectious disaster crisis period. Results: Severe patients visited regional emergency centers (RECs) and local emergency centers (LECs) more frequently duringthe COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more commonin RECs and LECs during the COVID-19 period [RECs, before COVID-19: 300686 (6.3%), during COVID-19: 33548 (8.0%)(p<0.001); LECs, before COVID-19: 373593 (3.7%), during COVID-19: 38873 (4.5%) (p<0.001)]. Conclusion: During the COVID-19 period, severe patients were shifted to advanced emergency medical institutions, and theKTAS better reflected severe patients. Patient distribution according to the stage of emergency medical institution improved, andvalidation of the KTAS triage increased more in RECs.
Abstract
Purpose: Severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19), has spreadworldwide. Global health systems, including emergency medical systems, are suffering from a lack of medical resources. Using amethod for classifying patients visiting the emergency department (ED), we aimed to investigate trends in emergency medicalsystem usage during the COVID-19 epidemic in Korea. Materials and Methods: This retrospective observational study included patients who visited emergency medical institutionsregistered with the National Emergency Department Information System database from January 1, 2017 to May 31, 2020. The primaryoutcome was identification of changes in the distribution of patients visiting the ED according to the type of emergencymedical institution. The secondary outcome was a detailed comparison of Korean Triage and Acuity Scale (KTAS) levels and patientdistributions before and during the infectious disaster crisis period. Results: Severe patients visited regional emergency centers (RECs) and local emergency centers (LECs) more frequently duringthe COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more commonin RECs and LECs during the COVID-19 period [RECs, before COVID-19: 300686 (6.3%), during COVID-19: 33548 (8.0%)(p<0.001); LECs, before COVID-19: 373593 (3.7%), during COVID-19: 38873 (4.5%) (p<0.001)]. Conclusion: During the COVID-19 period, severe patients were shifted to advanced emergency medical institutions, and theKTAS better reflected severe patients. Patient distribution according to the stage of emergency medical institution improved, andvalidation of the KTAS triage increased more in RECs.
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