The association between demographic, economic, and medical resource factors and the inflow and outflow of critically ill emergency patients by medical service districts in South Korea

This study identified the in- and outflow of critically ill emergency patients in 70 medical service districts, categorized them into regional types, and analyzed their association with demographics, economy, and medical resources in South Korea. This study analyzed 922,108 emergency department (ED) visits for severe diseases from 01 January to 31 December 2021. The relevance (RI) and commitment (CI) indices were calculated, followed by cluster analysis to categorize region types for critical care. Demographic, economic, and medical resource factors were compared and analyzed for each district type. Finally, a correlation analysis and multiple linear regression analysis were conducted to compare the association of demographic, economic, and medical resources with RI and CI. The district types were divided into 21 outflow and 49 inflow districts. Additionally, RI was associated with the number of primary clinics (β = −0.805), the average number of performed computed tomography scanners (β = 1.320), the average number of performed magnetic resonance imaging (MRI) scanners (β = −1.125), and the average number of dedicated specialists in the ED (β = 1.176) (p < 0.01). The CI was associated with the financial autonomy rate (β = 0.366), the number of primary clinics (β = 0.708), the number of intensive care units (ICUs) (β = −1.290), the number of vulnerable areas for emergency medicine (β = 0.395), the average number of dedicated specialists in the ED (β = −0.512), and the number of beds in the ED (β = 0.915) (p < 0.01). The lower the average number of MRIs and the number of primary clinics, the greater the outflow of critically ill emergency patients from the central region. The higher the number of ICUs and the average number of dedicated specialists in the ED, the greater the inflow of critically ill emergency patients from other districts.

Critically ill emergency patient; Medical service district; Inflow; Outflow

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