Association between health insurance status and transfer of patients with return of spontaneous circulation after out-of-hospital cardiac arrest
- Authors
- Park, Chi Ho; Ahn, Ki Ok; Shin, Sang Do; Park, Jeong Ho; Lee, Sun Young
- Issue Date
- Apr-2020
- Publisher
- ELSEVIER IRELAND LTD
- Keywords
- Out-of-hospital cardiac arrest; Patient transfer; Socioeconomic status
- Citation
- RESUSCITATION, v.149, pp.143 - 149
- Indexed
- SCIE
SCOPUS
- Journal Title
- RESUSCITATION
- Volume
- 149
- Start Page
- 143
- End Page
- 149
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/145891
- DOI
- 10.1016/j.resuscitation.2020.02.018
- ISSN
- 0300-9572
- Abstract
- Aim: To explore the factors related to the probability of inter-hospital transfer to a heart attack centre in patients with return of spontaneous circulation after out-of-hospital cardiac arrest (OHCA) in the Republic of Korea.
Methods: This cross-sectional observational study used data from a Korean national emergency medical service OHCA database for cases between 2015 and 2017. Adult OHCA patients with a presumed cardiac origin who initially presented at a non-heart-attack centre were included in the analysis. The main exposure variable was health insurance type (national health insurance versus medical aid), which was used as a proxy measure of individual socioeconomic status. The primary outcome was emergency department disposition (transfer to a heart attack centre versus no transfer). A multivariate logistic analysis using propensity score matching was conducted. We also analysed the associations between patient transfer and neurologic recovery as well as survival to discharge.
Results: Of 7804 eligible OHCA patients, 1804 23.0%) were transferred to a heart attack centre. Patients on medical aid were less likely to be transferred (adjusted odds ratio [OR], 0.75; 95% confidence interval [CI], 0.59-0.95 in a matched cohort) compared with patients with national health insurance. Transfer to a heart attack centre was significantly associated with a lower risk of death (adjusted OR, 0.38; 95% CI, 0.33-0.45) and better neurologic recovery (adjusted OR, 0.46; 95% CI, 0.38-0.56).
Conclusion: Socioeconomic status appears likely to influence the probability of transfer to a heart attack centre after resuscitation.
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