Comparative length of emergency department stay of patients with different Korean Triage and Acute Scale severities: A descriptive analysis
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Purpose: The severity classification in association with the time of visit to and the appropriateness of using a public ambulance for visiting the emergency department (ED) have not been thoroughly evaluated, and we aimed to evaluate these aspects. Methods: In this descriptive research, we retrospectively reviewed and analyzed the medical records of patients who visited the ED of the B General Hospital, Seoul from January to December 2019. Results: Of the 54,297 patients who were included in the analysis, 34,629 (63.8%) and 14,065 (25.9%) visited the ED directly and through public ambulances, respectively; 10,328 (73.4%) patients who used public ambulances were discharged home. In the daytime and nighttime, 24,891 (45.8%) and 29,406 (54.2%), respectively, visited the ED. The mean length of ED stay (LoS) of emergency and non-emergency patients was 326 and 159 minutes, respectively, and of patients classified as Korean Triage and Acuity Scale levels 1 and 2 was 427 and 430 minutes, respectively, which was longer than the total of 236 minutes. Conclusion: Patients who visited the ED using public ambulances constituted nearly 25% of all ED visits, and more than 70% of these patients were discharged home. Patients with high severity had a longer mean LoS, and daytime ED visits were characterized by higher numbers and severity of patients than nighttime ED visits.
Abstract
Purpose: The severity classification in association with the time of visit to and the appropriateness of using a public ambulance for visiting the emergency department (ED) have not been thoroughly evaluated, and we aimed to evaluate these aspects. Methods: In this descriptive research, we retrospectively reviewed and analyzed the medical records of patients who visited the ED of the B General Hospital, Seoul from January to December 2019. Results: Of the 54,297 patients who were included in the analysis, 34,629 (63.8%) and 14,065 (25.9%) visited the ED directly and through public ambulances, respectively; 10,328 (73.4%) patients who used public ambulances were discharged home. In the daytime and nighttime, 24,891 (45.8%) and 29,406 (54.2%), respectively, visited the ED. The mean length of ED stay (LoS) of emergency and non-emergency patients was 326 and 159 minutes, respectively, and of patients classified as Korean Triage and Acuity Scale levels 1 and 2 was 427 and 430 minutes, respectively, which was longer than the total of 236 minutes. Conclusion: Patients who visited the ED using public ambulances constituted nearly 25% of all ED visits, and more than 70% of these patients were discharged home. Patients with high severity had a longer mean LoS, and daytime ED visits were characterized by higher numbers and severity of patients than nighttime ED visits.
참고문헌 (44)
- Richard D. Hardern, "Critical Appraisal of Papers Describing Triage Systems", Academic Emergency Medicine, 6(11), pp.1166~1171 (1999), Wiley[DOI]
- Akira Kuriyama, "Five-level emergency triage systems: variation in assessment of validity", Emergency Medicine Journal, 34(11), pp.703~710 (2017), BMJ[DOI]
- Nicki Gilboy, "Re-evaluating triage in the new millennium: A comprehensive look at the need for standardization and quality", Journal of Emergency Nursing, 25(6), pp.468~473 (1999), Elsevier BV[DOI]
- Richard C. Wuerz, "Reliability and Validity of a New Five-level Triage Instrument", Academic Emergency Medicine, 7(3), pp.236~242 (2000), Wiley[DOI]
- A I Grouse, "The Manchester Triage System provides good reliability in an Australian emergency department", Emergency Medicine Journal, 26(7), pp.484~486 (2009), BMJ[DOI]
- Nicola Parenti, "A systematic review on the validity and reliability of an emergency department triage scale, the Manchester Triage System", International Journal of Nursing Studies, 51(7), pp.1062~1069 (2014), Elsevier BV[DOI]
- George A Jelinek, "Inter-rater reliability of the National Triage Scale over 11,500 simulated occasions of triage", Emergency Medicine, 8(4), pp.226~230 (2009), Wiley[DOI]
- Michael Murray, "Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines", CJEM, 6(06), pp.421~427 (2004), Springer Science and Business Media LLC[DOI]
- 박준범, "한국형 응급환자 분류도구의 이해", 대한응급의학회지, 28(6), pp.547~551 (2017), 대한응급의학회
- 김진영, "응급센터를 방문한 성인 환자의 중증도 분류 지표로서 한국형 중증도 분류체계의 신뢰도 분석: 일개 지역응급의료센터의 예비연구", 대한응급의학회지, 28(6), pp.552~556 (2017), 대한응급의학회
- 신진욱, "일개 어린이병원 응급실에서 시행한 새롭게 개발된 소아 5단계 중증도 분류의 타당도 연구", 대한응급의학회지, 28(6), pp.557~563 (2017), 대한응급의학회
- 이경재, "119구급대를 통해 응급실을 방문한 소아환자의 중증도분류 결과: 일개 권역응급의료센터 관찰 연구", 대한소아응급의학회지, 4(1), pp.18~24 (2017), 대한소아응급의학회[DOI]
- Lim T, "Pediatric Korean triage and acuity scale", Pediatr Emerg Med J, 2(2), pp.53~58 (2015)
- 김형일, "한국형 응급환자 분류도구(Korean Triage and Acuity Scale) 적용 시 의사-간호사 간의 일치율 분석", 대한응급의학회지, 30(4), pp.309~317 (2019), 대한응급의학회
- 문선희, "한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성", 한국산학기술학회논문지, 19(11), pp.626~634 (2018), 한국산학기술학회[DOI]
- Morten Breinholt Søvsø, "Contacting out-of-hours primary care or emergency medical services for time-critical conditions - impact on patient outcomes", BMC Health Services Research, 19(1), pp.813~ (2019), Springer Science and Business Media LLC[DOI]
- Görkem Sarıyer, "Factors affecting length of stay in the emergency department: A research from an operational viewpoınt", International Journal of Healthcare Management, 13(sup1), pp.173~182 (2018), Informa UK Limited[DOI]
- Emily Andrew, "Drivers of Increasing Emergency Ambulance Demand", Prehospital Emergency Care, 24(3), pp.385~393 (2019), Informa UK Limited[DOI]
- 왕일재, "응급실 퇴실배치와 한국형 응급환자 분류체계를 통한 응급여부, 내원수단의 관계", 대한응급의학회지, 29(2), pp.144~151 (2018), 대한응급의학회
- Jeremiah S. Hinson, "Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis", International Journal of Emergency Medicine, 11(1), pp.3~ (2018), Springer Science and Business Media LLC[DOI]
- Atilio Moreno-Carrillo, "Application of queuing theory to optimize the triage process in a tertiary emergency care (“ER”) department", Journal of Emergencies, Trauma, and Shock, 12(4), pp.268~273 (2019), Medknow[DOI]
- Thereza Raquel Machado Azeredo, "Efficacy of the Manchester Triage System: a systematic review", International Emergency Nursing, 23(2), pp.47~52 (2015), Elsevier BV[DOI]
- "Reliability and validity verification study of the Korean Triage and Acuity Scale" (2014)[URL]
- 김무현, "서울지역 일개 지역응급의료센터에 내원한 환자의 보험급종별 응급실 이용행태 분류", 한국응급구조학회지, 24(1), pp.25~36 (2020), 사단법인 한국응급구조학회
- Claire Pearson, "Emergency department visits in patients with low acuity conditions: Factors associated with resource utilization", The American Journal of Emergency Medicine, 36(8), pp.1327~1331 (2018), Elsevier BV[DOI]
- Kathrin Hegenberg, "Differences between cases admitted to hospital and discharged from the emergency department after emergency medical services transport", BMJ Open, 9(9), pp.e030636~ (2019), BMJ[DOI]
- A. Zachary Hettinger, "Emergency Medical Dispatch Codes Association with Emergency Department Outcomes", Prehospital Emergency Care, 17(1), pp.29~37 (2012), Informa UK Limited[DOI]
- Ho Ting Wong, "Identifying rural–urban differences in the predictors of emergency ambulance service demand and misuse", Journal of the Formosan Medical Association, 118(1), pp.324~331 (2019), Elsevier BV[DOI]
- Gabriella Norberg, "Swedish emergency medical services’ identification of potential candidates for primary healthcare: Retrospective patient record study", Scandinavian Journal of Primary Health Care, 33(4), pp.311~317 (2015), Informa UK Limited[DOI]
- Wankhade P, "The crisis in NHS Ambulance Services in the UK: Let’s deal with the ‘elephants in the room’!!", Ambulance Today, 15(1), pp.13~17 (2018)
- Alicia O’Cathain, "Understanding variation in ambulance service non-conveyance rates: a mixed methods study", Health Services and Delivery Research, 6(19), pp.1~192 (2018), National Institute for Health Research[DOI]
- H A Snooks, "On-scene alternatives for emergency ambulance crews attending patients who do not need to travel to the accident and emergency department: a review of the literature", Emergency Medicine Journal, 21(2), pp.212~215 (2004), BMJ[DOI]
- Joanne Coster, "Outcomes for Patients Who Contact the Emergency Ambulance Service and Are Not Transported to the Emergency Department: A Data Linkage Study", Prehospital Emergency Care, 23(4), pp.566~577 (2019), Informa UK Limited[DOI]
- 이정찬, "응급실 다방문 결정 요인: 종합병원급 이상 권역응급의료센터를 중심으로", 대한보건연구, 44(3), pp.129~146 (2018), 사단법인 대한보건협회[DOI]
- 윤형완, "119 구급서비스 유료화에 관한 응급의료전문가 델파이 조사 연구", 대한응급의학회지, 28(2), pp.190~200 (2017), 대한응급의학회
- Iben Duvald, "Linking the severity of illness and the weekend effect: a cohort study examining emergency department visits", Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 26(1), pp.72~ (2018), Springer Science and Business Media LLC[DOI]
- Tomoya Hirose, "Impact of nighttime and weekends on outcomes of emergency trauma patients", Medicine, 99(1), pp.e18687~ (2020), Ovid Technologies (Wolters Kluwer Health)[DOI]
- 서정화, "응급실 다빈도 이용 환자에서 응급도에 영향을 미치는 인자", 대한응급의학회지, 30(6), pp.473~783 (2019), 대한응급의학회
- 정성필, "응급실 체류시간 제한이 과밀화 및 진료의 질에 미치는 영향: 체계적 문헌고찰과 메타분석", 대한응급의학회지, 29(2), pp.170~178 (2018), 대한응급의학회
- P. Williams, "Efficacy of a triage system to reduce length of hospital stay", British Journal of Psychiatry, 204(6), pp.480~485 (2014), Royal College of Psychiatrists[DOI]
- Hyuksool Kwon, "The Korean Triage and Acuity Scale: associations with admission, disposition, mortality and length of stay in the emergency department", International Journal for Quality in Health Care, 31(6), pp.449~455 (2018), Oxford University Press (OUP)[DOI]
- 김지혁, "응급센터를 내원한 성인 환자의 중증도 분류 지표로서 한국형 중증도분류체계 (KTAS)의 타당도 분석: 일개 지역응급의료센터의 예비연구", 대한응급의학회지, 27(5), pp.436~441 (2016), 대한응급의학회
- 이인혜, "한국형 응급환자 분류도구(Korean Triage and Acuity Scale) 타당도 분석", 대한응급의학회지, 29(1), pp.13~20 (2018), 대한응급의학회
- Michael Hocker, "NHAMCS Validation of Emergency Severity Index as an Indicator of Emergency Department Resource Utilization", Western Journal of Emergency Medicine, 19(5), pp.855~862 (1996), Western Journal of Emergency Medicine[DOI]
