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

Abstract

PurposeThe 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 MethodsThe 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.ResultsAlthough 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.ConclusionKorean 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.

One-year Survival Rates and Functional Recovery in Veterans Who Suffer from Hip Fractures: Evaluation of Commissioned Hospitals' System through Comparison between Veterans Hospitals and Commissioned Hospitals

“…In Korea, the number of veteran patients is decreasing annually and travel from residences to downtowns is becoming increasingly convenient with well-developed public transport and road networks. Little time is spent traveling from residence to a CH 20) , and no waiting for inpatient admission or surgery delay occurred in either hospital groups in our study, implying that the current number of CHs is sufficient 21) . Hutt et al 9) suggest that non-VH survival rates are superior to those at VH facilities because Veterans' Health Administration patients were more ethnically diverse, and have greater comorbidities than non-veterans.…”