Choi WooSung, Lim YongSu, Heo Tag, Lee SungMin, Kim Won, Kim Sang-Chul, Kim YeonWoo, Kim JaeHyuk, Kim Hyun, Kim HyungIl, Lee TaeHun, Kim Chol
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea.
Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea.
J Clin Med. 2023 Sep 28;12(19):6252. doi: 10.3390/jcm12196252.
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.
(1) 背景：韩国政府通过指定城乡医院建立了一个全国性的基于网络和移动的紧急远程会诊网络。本研究的目的是分析韩国远程急救系统的特点和有效性。(2) 方法：本研究分析了2015年5月至2018年12月期间的远程急救会诊病例。本研究中远程急救的定义是城乡医院的医生通过基于网络和移动的远程急救会诊系统（RECS）进行的紧急会诊。通过RECS进行的会诊分为三类：医疗程序或治疗指导、影像解读和转运请求。本研究分析了远程急救系统的特点以及不必要转运的减少情况（RUT）。(3) 结果：本研究从2985例远程急救会诊病例中总共分析了2604例。共有381例因数据缺失而被排除。影像解读会诊在创伤病例中最为常见（71.3%），而转运请求在非创伤病例中最为常见（50.3%）。创伤患者在会诊后更频繁地入住农村医院或出院并在农村医院进行随访（20.3% 对 40.5%）。就疾病严重程度而言，创伤病例中的非严重病例在统计学上更高（80.6% 对 59.4%；P < 0.001）。RUT与创伤病例在统计学上高度相关（60.8% 对 42.8%；P < 0.001）。在按地区对病例进行分类的分析中，岛屿地区使用转运的比例在统计学上更高（69.9% 对 49.5%；P < 0.003）。更多的RUT与非岛屿地区相关（30.1% 对 50.5%；P = 0.001）。(4) 结论：远程急救系统在减少非严重创伤病例和非岛屿农村地区紧急病例中不必要的患者转运方面发挥了重要作用。需要进一步研究进行成本/效益分析和临床结果评估。
