응급의료센터의 접수 취소 현황에 대한 고찰

Abstract

Purpose: The cancellation of reception in emergency department (ED) in Korea is similar to leaving without being seen in another country. But there are differences. We studied the actual conditions and reasons for cancellation of reception in the ED in each of several hospitals. Methods: Thirty-six emergency centers and one hundred sixty-seven emergency physicians participated in this survey. We obtained information through a questionnaire about total hospital bed counts, emergency center bed counts, number of emergency physicians, number of cancellations of reception for one day, and emergency physicians'opinions about cancellation of reception. Also, we prospectively investigated reasons for cancellation of reception for emergency physicians and patients. We recorded the reason for cancellation of reception at the time of cancellation and then interviewed the patient by telephone within 10 days after their leaving the ED. Results: Nine regional emergency centers, three specialized emergency centers, twenty-two local emergency centers and two local emergency facilities were involved in this study. We surveyed patient cancellation of reception from August 1, 2008, to October 31, 2008 in our hospital. The results of our study were variable but the average of cancellation of reception was 10% of all ED patients. The most common reason for cancellation of reception was the emergency physician sending the patient to an outpatient clinic,typically because they thought the patient had mild symptoms. The most common reasons causing emergency physicians to think about cancellation of reception were mild symptoms and too long a delay time. There was a significant difference of opinion between emergency physician and patient regarding cancellation of reception (p<0.01). The emergency physicians considered the reasons to be patient factors, while the patients considered the reasons to be doctor-related factors. Conclusion: There are many adverse effects from cancellation of reception in an ED for both emergency physicians and patients. We should considered methods for developing a consensus on ways to improve the situation.