응급의료센터 성과 평가 기준개발과 적용

Performance Evaluation of Emergency Medical Center

  • 강철환 (국군의무사령부 예방의학과) ;
  • 김윤 (서울대학교 의과대학 의료관리학교실) ;
  • 이평수 (한국보건의료관리연구원) ;
  • 권영대 (한국보건의료관리연구원) ;
  • 김창엽 (서울대학교 의과대학 의료관리학교실) ;
  • 신영수 (서울대학교 의과대학 의료관리학교실)
  • Kang, Chul-Hwan (Department of Preventive Medicine, Armed Forces in Medical Command) ;
  • Kim, Yoon (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Lee, Pyung-Soo (Korea Institute of Health Services Management) ;
  • Kwon, Young-Dae (Korea Institute of Health Services Management) ;
  • Kim, Chang-Yup (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Shin, Young-Soo (Department of Health Policy and Management, Seoul National University College of Medicine)
  • 발행 : 1997.12.01

초록

Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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