韩国儿科急诊就诊特点：一项基于韩国健康面板数据的观察性研究。
The characteristics of pediatric emergency department visits in Korea: An observational study analyzing Korea Health Panel data.
机构信息
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
出版信息
PLoS One. 2018 May 24;13(5):e0197929. doi: 10.1371/journal.pone.0197929. eCollection 2018.
OBJECTIVE
We investigated the characteristics of pediatric emergency department (ED) patients in Korea and determined factors associated with hospital admission after ED treatment.
METHODS
Korea Health Panel data from 2008 through 2013 were analyzed retrospectively; we included patients under 18 years old who visited the ED at least once. We collected patient and household epidemiologic data such as sex, age group, region of residence, disability, chronic disease, household income quintile, national health insurance type, use of private insurance, and annual frequency of ED visits. We also examined data related to each ED visit, such as reason for visit, medical service provided, and hospital size/ownership. We then investigated which factors were correlated with case disposition (discharge home or hospital admission) after ED treatment.
RESULTS
In total, 3,160 pediatric ED visits occurred during the six-year period. Males (57.5%) and children aged 0-5 years (47.7%) made more visits than females and older children, respectively. The proportion of ED visits for disease (67.7%) was much higher than for injury or poisoning (32.2%), and 452 cases (14.3%) required hospital admission. For hospital admission, the odds ratio (OR) of females was 0.73 compared to males, and the OR of children aged 6-11 was 0.68 compared to children aged 0-5. The OR of capital residents was 0.69 compared to province residents, and the OR of the highest income quintile was 0.51 compared to the lowest quintile. The OR of children with private insurance coverage was 0.49 compared to those lacking private insurance, and the OR of ED visits due to disease was 1.82 compared to visits due to injury/poisoning.
CONCLUSION
This analysis of clinical and demographic characteristics of pediatric ED visits and hospital admissions can serve as the foundation of future prospective studies required for establishing appropriate policies for the Korean pediatric emergency medical system.
目的
本研究旨在调查韩国儿科急诊（ED）患者的特征，并确定 ED 治疗后住院的相关因素。
方法
本研究回顾性分析了 2008 年至 2013 年的韩国健康面板数据，纳入至少一次就诊 ED 的 18 岁以下患者。收集患者和家庭的流行病学数据，如性别、年龄组、居住地区、残疾、慢性病、家庭收入五分位数、国家健康保险类型、私人保险使用情况和 ED 就诊的年频率。还检查了与每次 ED 就诊相关的数据，如就诊原因、提供的医疗服务和医院规模/所有权。然后，我们调查了 ED 治疗后与病例处置（出院或住院）相关的因素。
结果
在六年期间，共发生了 3160 例儿科 ED 就诊。男性（57.5%）和 0-5 岁儿童（47.7%）的就诊次数多于女性和年龄较大的儿童。疾病（67.7%）就诊的比例远高于损伤或中毒（32.2%），452 例（14.3%）需要住院治疗。对于住院治疗，女性的优势比（OR）为 0.73，与男性相比，6-11 岁儿童的 OR 为 0.68，与 0-5 岁儿童相比。首都居民的 OR 为 0.69，与省居民相比，收入最高五分位数的 OR 为 0.51，与最低五分位数相比。有私人保险的儿童的 OR 为 0.49，与没有私人保险的儿童相比，疾病就诊的 OR 为 1.82，与损伤/中毒就诊相比。
结论
本研究对儿科 ED 就诊和住院的临床和人口统计学特征进行了分析，可为未来制定韩国儿科急诊医疗系统的适当政策提供基础。
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