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2015 年中东呼吸综合征疫情对韩国急救利用和死亡率的影响。

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea.

机构信息

Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.

Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.

出版信息

Yonsei Med J. 2019 Aug;60(8):796-803. doi: 10.3349/ymj.2019.60.8.796.

Abstract

PURPOSE

In May 2015, South Korea experienced an epidemic of Middle East respiratory syndrome (MERS). This study investigated the impacts of MERS epidemic on emergency care utilization and mortality in South Korea.

MATERIALS AND METHODS

A natural experimental study was conducted using healthcare utilization and mortality data of the entire Korean population. The number of monthly emergency room (ER) visits was investigated to identify changes in emergency care utilization during the MERS epidemic; these trends were also examined according to patients' demographic factors, disease severity, and region. Deaths within 7 days after visiting an ER were analyzed to evaluate the impact of the reduction in ER visits on mortality.

RESULTS

The number of ER visits during the peak of the MERS epidemic (June 2015) decreased by 33.1% compared to the average figures from June 2014 and June 2016. The decrease was observed in all age, sex, and income groups, and was more pronounced for low-acuity diseases (acute otitis media: 53.0%; upper respiratory infections: 45.2%) than for high-acuity diseases (myocardial infarctions: 14.0%; ischemic stroke: 16.6%). No substantial changes were detected for the highest-acuity diseases, with increases of 3.5% for cardiac arrest and 2.4% for hemorrhagic stroke. The number of deaths within 7 days of an ER visit did not change significantly.

CONCLUSION

During the MERS epidemic, the number of ER visits decreased in all age, sex, and socioeconomic groups, and decreased most sharply for low-acuity diseases. Nonetheless, there was no significant change in deaths after emergency care.

摘要

目的

2015 年 5 月,韩国发生中东呼吸综合征(MERS)疫情。本研究旨在探讨 MERS 疫情对韩国急诊医疗利用和死亡率的影响。

材料与方法

采用全韩国人口的医疗利用和死亡率数据进行自然实验研究。调查每月急诊就诊次数,以确定 MERS 疫情期间急诊医疗利用的变化;并根据患者的人口统计学因素、疾病严重程度和地区进行趋势分析。分析急诊就诊后 7 天内的死亡人数,以评估急诊就诊减少对死亡率的影响。

结果

MERS 疫情高峰期(2015 年 6 月)的急诊就诊人数较 2014 年 6 月和 2016 年 6 月的平均水平下降了 33.1%。所有年龄、性别和收入组均观察到下降,低危疾病(急性中耳炎:53.0%;上呼吸道感染:45.2%)降幅大于高危疾病(心肌梗死:14.0%;缺血性卒中:16.6%)。最高危疾病未发生实质性变化,心搏骤停增加 3.5%,出血性卒中增加 2.4%。急诊就诊后 7 天内的死亡人数无显著变化。

结论

在 MERS 疫情期间,所有年龄、性别和社会经济群体的急诊就诊人数均减少,低危疾病降幅最大。然而,急诊后死亡率无显著变化。

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