건강보험 청구자료를 활용한 응급의료 이용현황

Abstract

Background: The analysis of utilization trends in emergency patients is needed to set an efficient emergency medical system in Korea. We analyzed the number of utilization in emergency patients and their inter-hospital transfer rate. Methods: We analyzed the National Health Insurance (NHI) claims data in the year of 2014. The 5,714,547 cases were constructed from 8,625,758 claims which were inpatient through the emergency room and outpatient for emergency medicine. The utilization and transfer rates are analyzed by the characteristics of patients and medical facilities. Results: The transfer rate was 5.1% in total emergency patients and 8.4% in severe patients. The transfer rates were higher in patients with myocardial infarction (12.8%), stroke (13.9%), and severe trauma (11.6%). And 52.6% of transferred patients and 76.8% of transferred severe patients received main procedures at the transferred medical facilities. Patients who had not received main procedures at the first-visit medical facilities were transferred to the hospital located in the same region or Seoul. Conclusion: As a result of analyzing NHI claims data, there was a difference in the utilization and transferred rate from the results analyzed National Emergency Department Information System (NEDIS) data. It is necessary to establish an information system that can complement the strengths and weaknesses of the NHI claims data and NEDIS.