Kim Kyoung-Ho, Kwon In Ho, Lee Jun Yeob, Yeo Woon Hyung, Park Ha Young, Park Kyung Hye, Cho Junho, Kim Hyunjong, Kim Gun Bea, Park Deuk Hyun, Yoon Yoo Sang, Kim Yang Weon
Department of Emergency Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Emergency Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Healthc Inform Res. 2013 Dec;19(4):278-85. doi: 10.4258/hir.2013.19.4.278. Epub 2013 Dec 31.
This study considered whether there could be a change of mortality and length of stay as a result of inter-hospital transfer, clinical department, and size of hospital for patients with organophosphates and carbamates poisoning via National Patients Sample data of the year 2009, which was obtained from Health Insurance Review and Assessment Services (HIRA). The utility and representativeness of the HIRA data as the source of prognosis analysis in poisoned patients were also evaluated.
Organophosphate and carbamate poisoned patients' mortality and length of stay were analyzed in relation to the initial and final treating hospitals and departments, as well as the presence of inter-hospital transfers.
Among a total of 146 cases, there were 17 mortality cases, and the mean age was 56.8 ± 19.2 years. The median length of stay was 6 days. There was no inter-hospital or inter-departmental difference in length of stay. However, it significantly increased when inter-hospital transfer occurred (transferred 11 days vs. non-transferred 6 days; p = 0.037). Overall mortality rate was 11.6%. The mortality rate significantly increased when inter-hospital transfer occurred (transferred 23.5% vs. non-transferred 7.0%; p = 0.047), but there was no statistical difference in mortality on inter-hospital and inter-department comparison at the initial treating facility. However, at the final treating facility, there was a significant difference between tertiary and general hospitals (5.1% for tertiary hospitals and 17.3% for general hospitals; p = 0.024), although there was no significant inter-departmental difference.
We demonstrated that hospital, clinical department, length of stay, and mortality could be analyzed using insurance claim data of a specific disease group. Our results also indicated that length of stay and mortality according to inter-hospital transfer could be analyzed, which was previously unknown.
本研究通过2009年国家患者样本数据，探讨有机磷和氨基甲酸酯类中毒患者因医院间转诊、临床科室及医院规模不同，其死亡率和住院时间是否会发生变化。该数据来自健康保险审查与评估服务机构（HIRA）。同时，还评估了HIRA数据作为中毒患者预后分析来源的实用性和代表性。
分析有机磷和氨基甲酸酯类中毒患者的死亡率和住院时间，这些因素与初始和最终治疗医院及科室，以及医院间转诊情况有关。
在总共146例病例中，有17例死亡，平均年龄为56.8±19.2岁。住院时间中位数为6天。住院时间在医院间或科室间无差异。然而，当发生医院间转诊时，住院时间显著增加（转诊患者为11天，未转诊患者为6天；p = 0.037）。总体死亡率为11.6%。当发生医院间转诊时，死亡率显著增加（转诊患者为23.5%，未转诊患者为7.0%；p = 0.047），但在初始治疗机构，医院间和科室间死亡率比较无统计学差异。然而，在最终治疗机构，三级医院和综合医院之间存在显著差异（三级医院为5.1%，综合医院为17.3%；p = 0.024），尽管科室间无显著差异。
我们证明了可以使用特定疾病组的保险理赔数据来分析医院、临床科室、住院时间和死亡率。我们的结果还表明，可以分析因医院间转诊导致的住院时间和死亡率，这在以前是未知的。
