J Korean Neurol Assoc.
2022 May;40(2):127-136. 10.17340/jkna.2022.2.3.
Workload in Emergency Rooms among Clinical Specialties and Overburdened Neurologists
- Affiliations
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- 1Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
- 2Department of Neurology, Dong-A University College of Medicine, Busan, Korea
- 3Department of Neurology, Hanyang University Guri Hospital, Guri, Korea
- 4Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
- 5Department of Neurology, National Medical Center, Seoul, Korea
- 6Department of Neurology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
- 7Department Neurology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
- 8Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- 9Department of Neurology, Nowon Eulji Medical Center, Seoul, Korea
- 10Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
- KMID: 2529602
- DOI: http://doi.org/10.17340/jkna.2022.2.3
Abstract
- Background
To evaluate workload in emergency rooms (ERs) among clinical specialties including neurology and investigate characteristics of neurological consultations in ER.
Methods
A nationwide survey was conducted to evaluate the number of specialists, resident physicians/surgeons, and emergency consultations of each clinical specialty in Korean tertiary referral hospitals from 2018 to 2019. Characteristics of neurological emergency consultations during the same period were investigated in one of the hospitals that participated.
Results
A total of 23 hospitals were included. Four irrelevant clinical specialties were excluded. The number of neurology specialists and resident physicians were 12.5/hospital (4.1% of all specialists) and 6.4/hospital (3.4% of all resident physicians/surgeons), respectively, while the mean numbers of specialists and resident physicians or surgeons per clinical specialty were 13.7/hospital and 8.6/hospital, respectively. Neurological consultations accounted for 11.0% of all ER consultations for severe patients (Korean Triage and Acuity Scale level 1-3). Annual ER consultations for severe patients per neurology specialist was 274.1, which was only second to pediatrics (290.0). Annual ER consultations for severe patients per resident physician was 406.6 which was 1.6 times higher than the second highest (internal medicine, 247.0). Frequent conditions for neurological ER consultation were dizziness (24.8%), motor weakness (23.9%), headache (10.6%), dysarthria (9.9%), and seizures (7.7%). Frequent primary diagnoses were cerebrovascular diseases (29.0%) and episodic and paroxysmal disorders (24.9%).
Conclusions
Workloads of neurology specialists for ER consultation were significantly heavy, and the workload of neurology resident physicians was the heaviest among all specialties. This should be considered in health care policies.
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