Lee Kyoungdong, Seong Ba Ool, Yoo Moon-Won
University of Ulsan College of Medicine, Seoul, Korea.
Division of Gastrointestinal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2024 Dec;107(6):354-362. doi: 10.4174/astr.2024.107.6.354. Epub 2024 Dec 2.
In 2024, South Korea experienced a substantial shortage of medical practitioners, primarily residents and interns, owing to mass resignation from training hospitals. This study aimed to evaluate whether the quality of medical care declined because of this shortage by comparing postoperative complications before and during the period of mass resignation.
This retrospective observational study assessed patient outcomes among patients with gastric cancer before and during a period of mass resignation at a single tertiary training hospital. Outcomes analyzed included operation duration, length of hospital stays, and complication rates. The effects of the medical crisis on complication rates were analyzed using logistic regression.
A total of 218 and 31 patients underwent surgery during the control and crisis periods, respectively. During the control period, approximately 73 surgeries were performed between February 20 and June 10 each year, which was reduced to 31 during the crisis period. The operation duration (minutes) was 164.5 before the medical crisis and 154.0 during it (P = 0.19). The incidence of postoperative complications before and during the medical crisis was 22.02% (48 of 218) and 9.68% (3 of 31), respectively (P = 0.15). No severe complications (Clavien-Dindo grade ≥IIIa) were observed during the crisis period. Multivariate logistic regression revealed that sex and body mass index were significant variables associated with postoperative complications, but the effects of medical crisis were not.
Despite the medical crisis in South Korea, patient outcomes for gastric cancer surgery were sustained in terms of the frequency of postoperative complications.
2024年,由于培训医院的大规模辞职,韩国经历了执业医师的严重短缺,主要是住院医师和实习医师。本研究旨在通过比较大规模辞职之前和期间的术后并发症,评估医疗质量是否因这种短缺而下降。
这项回顾性观察性研究评估了一家单一的三级培训医院在大规模辞职之前和期间胃癌患者的治疗结果。分析的结果包括手术时长、住院时间和并发症发生率。使用逻辑回归分析医疗危机对并发症发生率的影响。
在对照期和危机期分别有218例和31例患者接受了手术。在对照期,每年2月20日至6月10日期间约进行73例手术,在危机期降至31例。医疗危机前手术时长(分钟)为164.5,危机期间为154.0(P = 0.19)。医疗危机前和期间术后并发症的发生率分别为22.02%(218例中的48例)和9.68%(31例中的3例)(P = 0.15)。在危机期未观察到严重并发症(Clavien-Dindo分级≥IIIa)。多因素逻辑回归显示,性别和体重指数是与术后并发症相关的显著变量,但医疗危机的影响并非如此。
尽管韩国出现了医疗危机,但胃癌手术患者的术后并发症发生率方面的治疗结果得以维持。