J Korean Med Sci.  2015 Nov;30(11):1540-1544. 10.3346/jkms.2015.30.11.1540.

Critical Care In Korea: Present and Future

Affiliations
  • 1Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. yskoh@amc.seoul.kr
  • 2Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea.
  • 3Department of Critical Care Medine, Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Critical (or intensive) care medicine (CCM) is a branch of medicine concerned with the care of patients with potentially reversible life-threatening conditions. Numerous studies have demonstrated that adequate staffing is of crucial importance for patient outcome. Adequate staffing also showed favorable cost-effectiveness in terms of ICU stay, decreased use of resources, and lower re-admission rates. The current status of CCM of our contry is not comparable to that of advanced countries. The global pandemic episodes in the past decade showed that our society is not well prepared for severe illnesses or mass casualty. To improve CCM in Korea, reimbursement of the government must be amended such that referral hospitals can hire sufficient number of qualified intensivists and nurses. For the government to address these urgent issues, public awareness of the role of CCM is also required.

Keyword

Critical Care Medicine; Korea; Intensivist

MeSH Terms

Critical Care/*organization & administration
*Forecasting
Intensive Care Units/*organization & administration
Needs Assessment/*organization & administration
Republic of Korea

Cited by  8 articles

Impact of the Dedicated Neurointensivists on the Outcome in Patients with Ischemic Stroke Based on the Linked Big Data for Stroke in Korea
Tae Jung Kim, Ji Sung Lee, Jae Sun Yoon, Mi Sun Oh, Ji-Woo Kim, Keun-Hwa Jung, Kyung-Ho Yu, Byung-Chul Lee, Sang-Bae Ko, Byung-Woo Yoon,
J Korean Med Sci. 2020;35(21):e135.    doi: 10.3346/jkms.2020.35.e135.

Characteristics and Prognosis of Hospitalized Patients at High Risk of Deterioration Identified by the Rapid Response System: a Multicenter Cohort Study
Sang Hyuk Kim, Ji Young Hong, Youlim Kim
J Korean Med Sci. 2021;36(32):e235.    doi: 10.3346/jkms.2021.36.e235.

Association between Medical Costs and the ProVent Model in Patients Requiring Prolonged Mechanical Ventilation
Jiyeon Roh, Myung-Jun Shin, Eun Suk Jeong, Kwangha Lee
Tuberc Respir Dis. 2019;82(2):166-172.    doi: 10.4046/trd.2018.0065.

Effect of Early Tracheostomy on Clinical Outcomes in Patients with Prolonged Acute Mechanical Ventilation: A Single-Center Study
Yewon Kang, Wanho Yoo, Youngwoong Kim, Hyo Yeong Ahn, Sang Hee Lee, Kwangha Lee
Tuberc Respir Dis. 2020;83(2):167-174.    doi: 10.4046/trd.2019.0082.

Effects of Appointing a Full-Time Neurointensivist to Run a Closed-Type Neurological Intensive Care Unit
Myung-Ah Ko, Jung Hwa Lee, Joong-Goo Kim, Suyeon Jeong, Dong-Wha Kang, Chae-Man Lim, Sang-Ahm Lee, Kwang-Kuk Kim, Sang-Beom Jeon
J Clin Neurol. 2019;15(3):360-368.    doi: 10.3988/jcn.2019.15.3.360.

Sequential Organ Failure Assessment score as a predictor of mortality in ventilated patients with multidrug-resistant bacteremia
Yeseul Oh, Jiyeon Roh, Jaemin Lee, Hyun Sung Chung, Kwangha Lee, Min Ki Lee
Acute Crit Care. 2020;35(3):169-178.    doi: 10.4266/acc.2020.00143.

Development of a prognostic scoring system in patients with pneumonia requiring ventilator care for more than 4 days: a single-center observational study
Yeseul Oh, Yewon Kang, Kwangha Lee
Acute Crit Care. 2021;36(1):46-53.    doi: 10.4266/acc.2020.00787.

Impact of institutional case volume on intensive care unit mortality
Christine Kang, Ho Geol Ryu
Acute Crit Care. 2023;38(2):151-159.    doi: 10.4266/acc.2023.00689.


Reference

1. Brilli RJ, Spevetz A, Branson RD, Campbell GM, Cohen H, Dasta JF, Harvey MA, Kelley MA, Kelly KM, Rudis MI, et al. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med. 2001; 29:2007–2019.
2. Carlson RW, Weiland DE, Srivathsan K. Does a full-time, 24-hour intensivist improve care and efficiency? Crit Care Clin. 1996; 12:525–551.
3. Young MP, Birkmeyer JD. Potential reduction in mortality rates using an intensivist model to manage intensive care units. Eff Clin Pract. 2000; 3:284–289.
4. Kim JH, Hong SK, Kim KC, Lee MG, Lee KM, Jung SS, Choi HS, Lee JH, Jung KS, Lee SS, et al. Influence of full-time intensivist and the nurse-to-patient ratio on the implementation of severe sepsis bundles in Korean intensive care units. J Crit Care. 2012; 27:414.e11–414.e21.
5. Cho J, Lee HJ, Hong SB, Suh GY, Park MS, Kim SC, Kwak SH, Lee MG, Lim JM, Lee HK. Structure of intensive care unit and clinical outcomes in critically ill patients with influenza A/H1N1 2009. Korean J Crit Care Med. 2012; 27:65–69.
6. Hanson CW 3rd, Deutschman CS, Anderson HL 3rd, Reilly PM, Behringer EC, Schwab CW, Price J. Effects of an organized critical care service on outcomes and resource utilization: a cohort study. Crit Care Med. 1999; 27:270–274.
7. Suarez JI, Zaidat OO, Suri MF, Feen ES, Lynch G, Hickman J, Georgiadis A, Selman WR. Length of stay and mortality in neurocritically ill patients: impact of a specialized neurocritical care team. Crit Care Med. 2004; 32:2311–2317.
8. Pronovost PJ, Needham DM, Waters H, Birkmeyer CM, Calinawan JR, Birkmeyer JD, Dorman T. Intensive care unit physician staffing: financial modeling of the Leapfrog standard. Crit Care Med. 2006; 34:S18–S24.
9. Kwak SH, Jeong CW. Current status of intensive care units registered as critical care subspecialty training hospitals in Korea. J Korean Med Sci. 2014; 29:431–437.
10. Wunsch H, Angus DC, Harrison DA, Collange O, Fowler R, Hoste EA, de Keizer NF, Kersten A, Linde-Zwirble WT, Sandiumenge A, et al. Variation in critical care services across North America and Western Europe. Crit Care Med. 2008; 36:2787–2793. e1–e9.
11. Tarnow-Mordi WO, Hau C, Warden A, Shearer AJ. Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit. Lancet. 2000; 356:185–189.
12. Weled BJ, Adzhigirey LA, Hodgman TM, Brilli RJ, Spevetz A, Kline AM, Montgomery VL, Puri N, Tisherman SA, Vespa PM, et al. Critical Care Delivery: The Importance of Process of Care and ICU Structure to Improved Outcomes: An Update From the American College of Critical Care Medicine Task Force on Models of Critical Care. Crit Care Med. 2015; 43:1520–1525.
13. Neuraz A, Guerin C, Payet C, Polazzi S, Aubrun F, Dailler F, Lehot JJ, Piriou V, Neidecker J, Rimmelé T, et al. Patient Mortality Is Associated With Staff Resources and Workload in the ICU: A Multicenter Observational Study. Crit Care Med. 2015; 43:1587–1594.
14. Ely EW, Bennett PA, Bowton DL, Murphy SM, Florance AM, Haponik EF. Large scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Am J Respir Crit Care Med. 1999; 159:439–446.
15. Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, Bates DW. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999; 282:267–270.
16. Ellinoy BR. Critical care pharmacist: an essential intensivist. Crit Care Med. 2001; 29:1092–1093.
17. Cook D, Rocker G. Dying with dignity in the intensive care unit. N Engl J Med. 2014; 370:2506–2514.
18. Mark NM, Rayner SG, Lee NJ, Curtis JR. Global variability in withholding and withdrawal of life-sustaining treatment in the intensive care unit: a systematic review. Intensive Care Med. 2015; 41:1572–1585.
19. Herridge MS, Tansey CM, Matté A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011; 364:1293–1304.
20. Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014; 370:1626–1635.
21. Balas MC, Vasilevskis EE, Burke WJ, Boehm L, Pun BT, Olsen KM, Peitz GJ, Ely EW. Critical care nurses' role in implementing the "ABCDE bundle" into practice. Crit Care Nurse. 2012; 32:35–38. 40–47. quiz 8
22. Wunsch H, Linde-Zwirble WT, Angus DC, Hartman ME, Milbrandt EB, Kahn JM. The epidemiology of mechanical ventilation use in the United States. Crit Care Med. 2010; 38:1947–1953.
23. Berenholtz SM, Dorman T, Ngo K, Pronovost PJ. Qualitative review of intensive care unit quality indicators. J Crit Care. 2002; 17:1–12.
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr