Ramos Quelly Mae Rivadillo, Kim Ki Hong, Park Jeong Ho, Shin Sang Do, Song Kyoung Jun, Hong Ki Jeong
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea.
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea; Department of Emergency Medicine, Seoul National University Hospital, Seoul, South Korea.
Resuscitation. 2021 Jan;158:143-150. doi: 10.1016/j.resuscitation.2020.11.029. Epub 2020 Dec 3.
This study aimed to examine whether county socioeconomic status (SES) is associated with emergency medical service (EMS) response time and dual dispatch response of out-of-hospital cardiac arrest (OHCA) patients using county property tax per capita in Korea.
All EMS-treated adults who suffered OHCAs were enrolled between 2015 and 2017, excluding cases witnessed by EMS providers. The main exposure was property tax per capita in the county where the OHCA occurred. The primary outcome was response time interval, with a secondary outcome of dual dispatch response. Negative binomial regression analysis to calculate incidence rate ratio (IRR) with a 95% confidence interval (CI) was conducted for EMS response time. A multivariable logistic regression analysis for response time interval (<8 min) and dual dispatch response was also conducted.
A total of 71,326 patients in 228 counties were enrolled. Compared to the lowest SES quartile, OHCA patients in the highest SES quartile had shorter median (interquartile range [IQR]) response time intervals (9.5 [5.9] minutes vs. 7.6 [4.2] minutes, IRR [95% CI] 0.95 [0.94-0.96], respectively). The AOR (95% CI) for response time within 8 min was 1.07 (1.01-1.13) for the highest SES quartile compared to the lowest SES quartile. Those in the highest SES quartile also had higher rates of dual dispatch response compared to those in the lowest quantile (50.9% vs 26.6%; AOR [95% CI]: 2.16 [2.03-2.30]).
In OHCA patients, those in a lower SES are associated with longer response times and lower dual dispatch response.
本研究旨在利用韩国各县人均财产税，探讨县社会经济地位（SES）是否与院外心脏骤停（OHCA）患者的紧急医疗服务（EMS）响应时间及双重调度响应相关。
纳入2015年至2017年间所有接受EMS治疗的成年OHCA患者，不包括EMS提供者目击的病例。主要暴露因素为OHCA发生所在县的人均财产税。主要结局为响应时间间隔，次要结局为双重调度响应。对EMS响应时间进行负二项回归分析以计算发病率比（IRR）及95%置信区间（CI）。还对响应时间间隔（<8分钟）和双重调度响应进行了多变量逻辑回归分析。
共纳入228个县的71326例患者。与SES最低四分位数组相比，SES最高四分位数组的OHCA患者中位（四分位间距[IQR]）响应时间间隔更短（分别为9.5[5.9]分钟和7.6[4.2]分钟，IRR[95%CI]分别为0.95[0.94 - 0.96]）。与SES最低四分位数组相比，SES最高四分位数组8分钟内响应时间的调整后比值比（AOR）（95%CI）为1.07（1.01 - 1.13）。SES最高四分位数组的双重调度响应率也高于最低四分位数组（50.9%对26.6%；AOR[95%CI]：2.16[2.03 - 2.30]）。
在OHCA患者中，SES较低者与更长的响应时间及更低的双重调度响应相关。
