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젊은 성인 환자와 노인 환자의 의료자원 사용 비교: 일개 응급의료센터 후향적 관찰연구

Comparison of medical resources usage between young adult patients and elderly patients: a single center, retrospective observational study

대한응급의학회지 2019년 30권 6호 p.490 ~ 500
오은찬 ( Oh Eun-Chan ) - 부산대학교병원 응급의학과

조석주 ( Cho Suck-Ju ) - 부산대학교병원 응급의학과
왕일재 ( Wang Il-Jae ) - 부산대학교병원 응급의학과
김형빈 ( Kim Hyung-Bin ) - 부산대학교병원 응급의학과
박순창 ( Park Soon-Chang ) - 부산대학교병원 응급의학과
이성화 ( Lee Sung-Hwa ) - 부산대학교병원 응급의학과
배병관 ( Bae Byung-Kwan ) - 부산대학교병원 응급의학과
조영모 ( Cho Young-Mo ) - 부산대학교병원 응급의학과
이대섭 ( Lee Dae-Sup ) - 양산부산대학교병원 응급의학과
여광희 ( Yeo Kwang-Hee ) - 부산대학교병원 외상외과
황성연 ( Hwang Seong-Youn ) - 성균관대학교 삼성창원병원 응급의학과

Abstract


Objective: Under the overcrowding conditions of large emergency departments, the proportion of elderly patients is increasing in Korea. This paper describes the necessity of the preparedness of Korean emergency departments and society for the rapidly aging population.

Method: This was a retrospective observational study. Patients who presented to a tertiary hospital emergency department (ED) in one year were included. The use of medical resources between young adult (≥20 and <65 years of age) and elderly patients (≥65 years of age) was compared.

Results: This study included 26,712 patients. The young adult group and the elderly group was 15,021 (56.2%) and 11,691 (43.8%), respectively. The ratio of firehouse ambulance visit mode (28.6%) and inter-facility transfer visit mode (18.9%) of the elderly group was higher compared to those of the young adult group (26.4% and 10.6%, P<0.001). The elderly group visited more at daytime (P<0.001). With aging, the admission ratios of the elderly group to the general ward (38.9%) and intensive care unit (13.0%) were higher than the young adult group (9.8% and 4.3%, P<0.001). The mean ED length of stay and mean length of hospitalization of the elderly group was longer than that of the young adult group (P<0.001). The medical cost of the elderly group was approximately three times higher than that of the young adult group.

Conclusion: Elderly patients required more emergency medical resources in both the prehospital and hospital stages. Korean emergency departments and society require efforts for not only expansion but also the appropriate use of medical resources in a rapidly aging population.

키워드

Health resources emergency department; Geriatric assessment; Geriatric health services
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