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J Korean Soc Emerg Med > Volume 17(5); 2006 > Article
Journal of The Korean Society of Emergency Medicine 2006;17(5): 385-394.
Preventable Trauma Deaths Rates and Management Errors in Emergency Medical System in Korea
Yoon Kim, Koo Young Jung, Kwang Hyun Cho, Hyun Kim, Hee Cheol Ahn, Se Hyun Oh, Jae Baek Lee, Su Jin Yu, Dong Ik Lee, Tai Ho Im, Sung Eun Kim, Jae Hyun Park
1Department of Health Policy and Management, Seoul National University College of Medicine, Korea.
2Department of Emergency Medicine, College of Medicine, Ewha Womans Univesity, Korea.
3Department of Emergency Medicine, Sangkye Eulji Hospital, Korea.
4Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Korea.
5Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University, Korea.
6Department of Emergency Medicine, Kangnung Hospital, Korea.
7Department of Emergency Medicine, College of Medicine, Chonbuk National University, Korea.
8Department of Emergency Medicine, Wonkwang University School of Medicine, Korea.
9Department of Emergency Medicine, Namwon Medical Center, Korea.
10Department of Emergency Medicine, Hanyang University, Korea.
11Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Korea.
12National Cancer Center, Korea. jaehyun@ncc.re.kr
ABSTRACT
PURPOSE:
The objectives of this study were 1) to estimate the preventable death rate in emergency medical system in Korea 2) to determine factors that affect preventability of trauma deaths 3) to identify management errors involved in preventable deaths.
METHODS:
The records of a 202 patients who died in the emergency departments or shortly after admission due to trauma at nine hospitals in three regions between from July 1, 2003, to June 30, 2004 were retrospectively reviewed by nine board certified physicians in emergency medicine using professional panel study methodology. Each panelist independently reviewed prehospital records, medical records, x-ray films, and inter-hospital transfer records using a structured survey format and preventability was determined by a unanimous agreement rule. The management errors that contributed to a preventable death were determined and classified as "structure-related"and "process-related"errors.
RESULTS:
Preventable deaths related to all management errors account for 39.6% of all trauma deaths. Whereas, 25.7% of preventable deaths were related to management errors in the studied hospitals. The preventability of trauma deaths were determined by the cause of death and the severity of injury. A total of 389 management errors are identified. Management errors occurred mostly in emergency departments (51.1%) and, in prehospital delivery (21.8%). Most of these errors were found to be processrelated (81.2%) rather then structure-related (18.8%).
CONCLUSION:
Preventable death rates in Korea are higher than other developed countries, which implies there is much to be improved in the quality of emergency medical services. We found this to be true especially, for processrelated errors, which need to be regularly assessed, and policy established that reduces preventable deaths.
Key words: Injuries, Emergency medical services, Trauma, Death rate, Treatment
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