J Korean Neurosurg Soc.  2020 Jul;63(4):519-531. 10.3340/jkns.2020.0026.

Current Status of Neurosurgical and Neurointensive Care Units in Korea : A Brief Report on Nationwide Survey Results

• Jo KW
• Kim H
• Yoo DS
• Hyun DK
• Cheong JH
• Park HK
• Park BJ
• Cho BM
• Kim YW
• Kim TH
• Han I
• Lee SW
• Kwon TH

• KMID: 2504647
• DOI: http://doi.org/10.3340/jkns.2020.0026

Abstract

Objective
: The purpose of this study is identify the operation status of the neurosurgical care units (NCUs) in neurosurgical residency training hospitals nationwide and determine needed changes by comparing findings with those obtained from the Korean Neurosurgical Society (KNS) and Korean Society of Neurointensive Care Medicine (KNIC) survey of 2010. Method : This survey was conducted over 1 year in 86 neurosurgical residency training hospitals and two neurosurgery specialist hospitals and focused on the following areas : 1) the current status of the infrastructure and operating systems of NCUs in Korea, 2) barriers to installing neurointensivist team systems, 3) future roles of the KNS and KNIC, and 4) a handbook for physicians and practitioners in NCUs. We compared and analyzed the results of this survey with those from a KNIC survey of 2010.
Results
: Seventy seven hospitals (87.5%) participated in the survey. Nineteen hospitals (24.7%) employed a neurointensivist or faculty member; Thirty seven hospitals (48.1%) reported high demand for neurointensivists, and 62 hospitals (80.5%) stated that the mandatory deployment of a neurointensivist improved the quality of patient care. Forty four hospitals (57.1%) believed that hiring neurointensivist would increase hospital costs, and in response to a question on potential earnings declines. In terms of potential solutions to these problems, 70 respondents (90.9%) maintained that additional fees were necessary for neurointensivists’ work, and 64 (83.1%) answered that direct support was needed of the personnel expenses for neurointensivists.
Conclusion
: We hope the results of this survey will guide successful implementation of neurointensivist systems across Korea.

Keyword

Intensive care units; Neurosurgery; Critical care; Prognosis; Republic of Korea

Figure

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  Fig. 1. A : Is the demand for neurointensivists high? B : And do you think the mandatory deployment of neurointensivists improves the quality of patient care?

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  Fig. 2. Survey respondents’ opinions on barriers to impelementing neurointensivists.

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  Fig. 3. Potential solutions to barriers. Values are presented as number of hospitals.

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  Fig. 4. Proposal of a new model based on distinguishing the original medical intensive care model from the qualifications needed of a neurosurgeon-operated neurosurgical care unit as a neurointensivist.

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  Fig. 5. Do you think a handbook is necessary and are you willing to participate in making a handbook?

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  Fig. 6. Hospital equipment status comparison between the 2010 and 2019 surveys. ICP : intracranial pressure, CBF : cerebral blood flow, TCD : transcranial Doppler.

Reference

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