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응급실 다빈도 이용 환자에서 응급도에 영향을 미치는 인자

The factors affecting the level of urgency in the frequent users of the emergency department

대한응급의학회지 2019년 30권 6호 p.473 ~ 483
서정화 ( Seo Jung-Hwa ) - 울산대학교 의과대학 울산대학교병원 응급의학과

이혜지 ( Lee Hye-Ji ) - 울산대학교 의과대학 울산대학교병원 응급의학과
박은지 ( Park Eun-Ji ) - 울산대학교 의과대학 울산대학교병원 생의과학연구소
김혜민 ( Kim Hye-Min ) - 울산대학교 의과대학 간호학과
이혜빈 ( Lee Hye-Bin ) - 울산대학교 의과대학 간호학과
김선휴 ( Kim Sun-Hyu ) - 울산대학교 의과대학 울산대학교병원 응급의학과

Abstract


Objective: This study was conducted to identify patients who actually require medical treatment in the frequent users of the emergency department (ED) and evaluate the factors affecting the level of urgency by Korean Triage and Acuity Scale.

Methods: We retrospectively reviewed the medical records of frequent users who used more than four times a year to the ED in 2015. They were triaged on every use of ED and divided into non-urgent group and urgent group based on an average triage scale of three. The characteristics were compared between both groups.

Results: The total 443 patients were frequent users and they used the ED 2,944 times. The urgent group included 92 patients, and their median number of ED uses were 4 times. The urgent group was older and higher rate of male than the non-urgent group. The more patients suffered from medical diseases such as diabetes, cerebrovascular disease, ischemic heart disease, other heart disease, lung disease, and kidney disease in the urgent group. There was no difference in education, and socioeconomic status, and ratio uses with same symptoms in both groups. At the end of the study two years later, 55% of the urgent group died.

Conclusion: The urgent group consists of 92 patients (21%) of the frequent emergent department users. The factors affecting the level of urgency are male sex, cerebrovascular disease, other heart disease, lung disease, and kidney disease as medical history. On the other hand, the psychiatric history and other minor diseases are factors affecting reversely the level of urgency.

키워드

Frequent user; Emergency department; Triage
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