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The South Korean health-care system in crisis.韩国医疗保健系统陷入危机。
Lancet. 2024 Jun 15;403(10444):2589. doi: 10.1016/S0140-6736(24)00766-9.
2
The unintended consequences of hospital strikes on patient outcomes evidence from multiple strikes in the Portuguese National Health Service.医院罢工对患者结果的意外后果:来自葡萄牙国家卫生服务系统多次罢工的证据。
Health Econ. 2022 Nov;31(11):2499-2511. doi: 10.1002/hec.4576. Epub 2022 Aug 5.
3
Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study.韩国大邱2019冠状病毒病(COVID-19)大流行期间急诊科住院医师罢工的影响:一项回顾性横断面研究。
J Yeungnam Med Sci. 2022 Jan;39(1):31-38. doi: 10.12701/yujm.2021.01130. Epub 2021 Aug 10.
4
Changes in Emergency Department Performance during Strike of Junior Physicians in Korea.韩国初级医生罢工期间急诊科绩效的变化
Emerg Med Int. 2021 Jul 8;2021:1786728. doi: 10.1155/2021/1786728. eCollection 2021.
5
Seasonal variation of peptic ulcer disease, peptic ulcer bleeding, and acute pancreatitis: A nationwide population-based study using a common data model.消化性溃疡病、消化性溃疡出血和急性胰腺炎的季节性变化:使用通用数据模型的全国性基于人群的研究。
Medicine (Baltimore). 2021 May 28;100(21):e25820. doi: 10.1097/MD.0000000000025820.
6
The impact of the nurses', doctors' and clinical officer strikes on mortality in four health facilities in Kenya.肯尼亚四家卫生机构的护士、医生和临床医生罢工对死亡率的影响。
BMC Health Serv Res. 2020 May 26;20(1):469. doi: 10.1186/s12913-020-05337-9.
7
Global patterns of seasonal variation in gastrointestinal diseases.胃肠道疾病季节性变化的全球模式。
J Postgrad Med. 2013 Jul-Sep;59(3):203-7. doi: 10.4103/0022-3859.118039.
8
A retrospective study of the impact of the doctors' strike in England on 21 June 2012.回顾 2012 年 6 月 21 日英格兰医生罢工对医疗服务的影响。
J R Soc Med. 2013 Sep;106(9):362-9. doi: 10.1177/0141076813490685. Epub 2013 Jun 6.
9
Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy.消化性溃疡住院的季节性模式:对意大利艾米利亚-罗马涅地区住院数据的分析。
BMC Gastroenterol. 2010 Apr 15;10:37. doi: 10.1186/1471-230X-10-37.
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韩国医疗危机之前和期间胃癌手术术后并发症的比较:一项回顾性观察研究。

Comparison of the postoperative complications for gastric cancer surgery before and during the medical crisis in South Korea: a retrospective observational study.

作者信息

Lee Kyoungdong, Seong Ba Ool, Yoo Moon-Won

机构信息

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.

出版信息

Ann Surg Treat Res. 2024 Dec;107(6):354-362. doi: 10.4174/astr.2024.107.6.354. Epub 2024 Dec 2.

DOI:10.4174/astr.2024.107.6.354
PMID:39669385
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11634390/
Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Despite the medical crisis in South Korea, patient outcomes for gastric cancer surgery were sustained in terms of the frequency of postoperative complications.

摘要

目的

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。

方法

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。

结果

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。

结论

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。