Hip Pelvis.  2017 Jun;29(2):97-103. 10.5371/hp.2017.29.2.97.

What Is Important in Selecting a Designated Hospital for the Korean Veterans with Hip Fractures?

• Park BJ
• Cho HM
• Choi YS
• Seo JW

• KMID: 2424237
• DOI: http://doi.org/10.5371/hp.2017.29.2.97

Abstract

PURPOSE
The Korea Veterans Health Service (KVHS) implemented the "˜designated hospital system' so that veterans can receive prompt medical attention at hospitals near their residences when experience medical emergencies, including hip fractures. We analyzed the hospital-selection process of Korean veterans following a hip fracture. We then evaluated (the validity and considerations) for choosing designated hospitals.
MATERIALS AND METHODS
The study population consisted of 183 veteran patients (84 treated at a single veterans hospital and the remaining 99 treated at 39 designated hospitals) who underwent hip fracture between January 2010 and February 2015 in the Honam region of South Korea. The subjects were divided into the "˜nearest group' (those who chose the hospital closest to their residences) and the "˜non-nearest group' (those who did not choose the hospital closest to their residences). We compared the age, ambulatory status, combined disease and fracture type, factors that we speculated may impact hospital choice.
RESULTS
Although the patients had difficulty moving due to hip fractures, 116 (63.4%) patients choose hospitals that were not closest to their residences. Patients with three or more comorbidities (P=0.028) and older ages (P=0.046) were statistically more likely to fall into the non-nearest group. Ambulatory status and fracture type were shown not to significantly impact choice between nearest and non-nearest hospital. Patients in the non-nearest group tended to seek care at larger hospitals.
CONCLUSION
Korean veterans with hip fractures tended to seek care at larger hospitals, regardless of distance. We must therefore consider the number of beds and departments when choosing designated hospitals.

Keyword

Hip fractures; Veterans; Designated hospital

MeSH Terms

Comorbidity
Emergencies
Hip Fractures*
Hip*
Hospitals, Veterans
Humans
Korea
Veterans Health
Veterans*

Figure

• 

  Fig. 1 Scatter plots according to distance traveled, number of beds and number of department in selected and unselected hospitals between the nearest and non-nearest groups.

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