Analysis of pre-hospital emergency medical services use feasibility with emergency department visit patient

Kim, Hyun-Jin; Kim, Jung-Youn; Yoon, Young-Hoon; Park, SungJun; Lee, Eu Sun

J Korean Soc Emerg Med > Volume 32(5); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(5): 422-431.

응급실에 내원하는 환자들의 병원전 구급차 이용의 적정성 분석

김현진

고려대학교 의과대학 응급의학교실

Analysis of pre-hospital emergency medical services use feasibility with emergency department visit patient

Department of Emergency Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence

Jung-Youn Kim ,Tel: 02-2626-1561, Fax: 02-2626-1562, Email: yellowwizard@hanmail.net,

Received: August 25, 2020; Revised: October 10, 2020 Accepted: November 2, 2020. Published online: October 31, 2021.

ABSTRACT

Objective:
Patients are taken to the emergency department (ED) via a variety of transport systems. Proper ambulance use is important for improving patients’ transport quality and using limited resources allotted by the system effectively. Korea is a country with a well-developed public ambulance system established by the government. Therefore, this study was conducted to analyze the overuse or underuse of the ambulance system by patients who visited the ED.
Method:
This study was conducted at the ED in three hospitals. A total of 459,647 patients visited these EDs over the three-year study period from 2016 to 2018. Medical records were investigated retrospectively. The study subjects were divided into three groups based on their triage score and ambulance use. Patients were classified into adequacy (Korean Triage and Acuity Scale [KTAS] 1-3, ambulance use or KTAS 4-5, non-ambulance use), underuse (KTAS 1-3, non-ambulance use) and overuse (KTAS 4-5, ambulance use) groups.
Results:
The mean age of patients was 46.7±26.0 years, and 237,118 (51.6%) were male. The adequacy group included 269,046 patients (58.5% of the patients). The underuse group had 162,575 patients (35.4%), and the overuse group included 328,026 patients (6.1%). Despite having KTAS level 1 or 2, the number of patients who did not use an ambulance was 14,792. Ambulances were used by 5,154 patients at KTAS 5 level.
Conclusion:
Many patients use ambulances appropriately, but overuse and underuse of ambulances can still be observed. Guidelines on ambulance use are necessary for the efficient use of emergency medical resources and the safety of patients.

Key words: Emergency medical services; Ambulances; Triage