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Journal of Trauma and Injury 2013;26(4):261-265.
Transfer Patterns of Multiple Trauma Patients in University Hospital after Acute Phase Management
Jong Min Lee, Ji Young Jang, Seung Hwan Lee, Jae Gil Lee
Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea. jakii@yuhs.ac
대학병원에서 급성기 치료가 완료된 다발성 외상환자의 전원 패턴
이종민, 장지영, 이승환, 이재길
연세대학교 의과대학 외과학교실
Received: 26 September 2013   • Revised: 25 October 2013   • Accepted: 25 October 2013
Abstract
PURPOSE
The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type.
METHODS
Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review.
RESULTS
The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038).
CONCLUSION
An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.
Key Words: Multiple trauma; Patient transfer; Insurance
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