Chi Ho Park1, Ki Ok Ahn2, Sang Do Shin3, Jeong Ho Park4, Sun Young Lee5. 1. Department of Emergency Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea. Electronic address: defauth@gmail.com. 2. Department of Emergency Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea. Electronic address: arendt75@hanyang.ac.kr. 3. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: shinsangdo@gmail.com. 4. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: timthe@gmail.com. 5. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea; National EMS Control Center, National Fire Agency, Sejong, Republic of Korea. Electronic address: sy2376@gmail.com.
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.
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.
Authors: Ji Woong Kim; Juhyung Ha; Taerim Kim; Hee Yoon; Sung Yeon Hwang; Ik Joon Jo; Tae Gun Shin; Min Seob Sim; Kyunga Kim; Won Chul Cha Journal: J Med Internet Res Date: 2021-07-05 Impact factor: 7.076