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Impact of Intensivist and Nursing Staff on Critically Ill Patient Mortality: A Retrospective Analysis of the Korean NHIS Cohort Data, 2011-2015

 Su Hwan Lee  ;  Jung Hwa Hong  ;  Young Sam Kim  ;  Eun Cheol Park  ;  Sun Min Lee  ;  Chang Hoon Han 
 YONSEI MEDICAL JOURNAL, Vol.62(1) : 50-58, 2021-01 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Cohort Studies ; Critical Illness / mortality* ; Critical Illness / nursing* ; Female ; Hospital Mortality ; Humans ; Intensive Care Units / statistics & numerical data* ; Male ; Middle Aged ; Nursing Staff / statistics & numerical data* ; Physicians / statistics & numerical data* ; Republic of Korea ; Retrospective Studies ; Tertiary Care Centers
Critical care ; intensive care unit ; intensivist ; mortality ; nursing staff
Purpose: Critical care medicine continues to evolve. However, critical care cases require increasing amount of medical resources. Intensive care unit (ICU) mortality significantly impacts the overall efficiency of healthcare resources within a system of limited medical resources. This study investigated the factors related to ICU mortality using long-term nationwide cohort data in South Korea. Materials and methods: This retrospective cohort study used data of 14905721 patients who submitted reimbursement claims to the Korean Health Insurance Service between January 1, 2011 and December 31, 2015. A total of 1498102 patients who were admitted to all ICU types, except neonatal and long-term acute care hospitals, were enrolled. Results: Of the total 1498102 participants, 861397 (57.5%) were male and 636705 (42.5%) were female. The mean age at admission was 63.4±18.2 years; most of the subjects were aged over 60 years. During the 5-year period, in-hospital mortality rate was 12.9%. In Cox analysis, both in-hospital and 28-day mortality rates were significantly higher in male patients and those of lower socioeconomic status. As age increased and the number of nursing staff decreased, the mortality risk increased significantly by two or three times. The mortality risk was lower in patients admitted to an ICU of a tertiary university hospital and an ICU where intensivists worked. Conclusion: The number of nursing staff and the presence of an intensivist in ICU were associated with the ICU mortality rate. Also, increasing the number of nursing staff and the presence of intensivist might reduce the mortality rate among ICU patients.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
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