Lee Soo In, Kang Saee Byel, Lee Sun Young, Choi Dong Sun
Department of Emergency Medicine, Seoul Medical Center, Seoul, Korea.
Public Healthcare Center, Seoul National University Hospital, Seoul, Korea.
Clin Exp Emerg Med. 2023 Jun;10(2):191-199. doi: 10.15441/ceem.22.355. Epub 2023 Feb 14.
The number and distribution of isolation rooms in Korea differ by region. The distribution of isolation beds in emergency departments may have affected ambulance travel time and burden on emergency medical service (EMS) during the COVID-19 pandemic.
This retrospective observational study analyzed EMS records in four regions of the Gyeonggi Province, Korea, from January 01, 2019 to December 31, 2020. The main exposure was the number of emergency department isolation rooms in each region. The primary outcome was call-to-return time for the EMS. The interaction effect of the number of regional isolation rooms on the call-to-return time during the COVID-19 pandemic was analyzed using a generalized linear model (GLM) and logistic regression.
A total of 781,246 cases was included in the analyses. During the COVID-19 pandemic, the call-to-scene time (before 8 minutes vs. after 9 minutes, P<0.05) and call-to-return time (before 46 minutes vs. after 52 minutes, P<0.05) for emergency patients increased significantly compared to before the pandemic. As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-return time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exponential β coefficient [exp(β)], 1.33; with 12.24 isolation rooms per million population: adjusted exp(β), 1.18). As the number of regional isolation rooms increased, the effect of COVID-19 on the call-to-scene time decreased significantly in the multivariable GLM with an interaction term (with 10.14 isolation rooms per million population: adjusted exp(β), 1.20; with 12.24 isolation rooms per million population: adjusted exp(β), 1.09).
During the pandemic, the increases in call-to-return time and call-to-scene time were smaller in regions with more isolation rooms per population.
韩国隔离病房的数量和分布因地区而异。在新冠疫情期间，急诊科隔离床位的分布可能影响了救护车出行时间和紧急医疗服务（EMS）的负担。
这项回顾性观察性研究分析了韩国京畿道四个地区2019年1月1日至2020年12月31日的EMS记录。主要暴露因素是各地区急诊科隔离病房的数量。主要结局是EMS的呼叫到返回时间。使用广义线性模型（GLM）和逻辑回归分析了新冠疫情期间地区隔离病房数量对呼叫到返回时间的交互作用。
分析共纳入781,246例病例。在新冠疫情期间，与疫情前相比，急诊患者的呼叫到现场时间（疫情前8分钟以内与疫情后9分钟以后，P<0.05）和呼叫到返回时间（疫情前46分钟以内与疫情后52分钟以后，P<0.05）显著增加。在有交互项的多变量GLM中，随着地区隔离病房数量的增加，新冠疫情对呼叫到返回时间的影响显著降低（每百万人口有10.14个隔离病房：调整后的指数β系数[exp(β)]，1.33；每百万人口有12.24个隔离病房：调整后的exp(β)，1.18）。在有交互项的多变量GLM中，随着地区隔离病房数量的增加，新冠疫情对呼叫到现场时间的影响显著降低（每百万人口有10.14个隔离病房：调整后的exp(β)，1.20；每百万人口有12.24个隔离病房：调整后的exp(β)，1.09）。
在疫情期间，每人口隔离病房较多的地区，呼叫到返回时间和呼叫到现场时间的增加幅度较小。
