Critical Care In Korea: Present and Future

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.

Impact of the Dedicated Neurointensivists on the Outcome in Patients with Ischemic Stroke Based on the Linked Big Data for Stroke in Korea

“…By contrast, three institutions with dedicated neurointensivisits already had stroke units for stroke patients, and the patients who need real ICU care were admitted to the NICU. Therefore, the baseline characteristics of the patients admitted to the ICU (using only AJ code) (n = 7,410) were not comparable, and more severe patients are in the NICU at the institutions with dedicated neurointensivists (initial NIHSS 14 IQR [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] in centers with neurointensivists [n = 473, 6.4%] vs. 6 IQR [2][3][4][5][6][7][8][9][10][11][12][13] in centers without neurointensivists [n = 6,937, 93.6%]) (Supplementary Table 1). Given that respiratory failure is the most common, but important complication in patients with NICU, we selected 1,045 patients with the support of mechanical ventilator among acute ischemic stroke (with neurointensivists group, n = 303 [64.1%, 303 out of 473] and without neurointensitivsts group, n = 1,102 [15.9%, 1,102 out of 6,937]), and then the baseline characteristics were comparable between the two groups ( Table 1).…”

“…In Korea, only 20%-30% of the ICUs have specialized neurointensivists. 6,10,11,25 The lower number of neurointensivists and neurocritical care teams in Korea is particularly alarming because many of the neurocritically ill ischemic stroke patients receive a lower level of critical care, and this may adversely affect their outcomes. A neurocritical care team with a specialized neurointensivist is required for the best organized management of patients with severe ischemic stroke.…”

“…1,[5][6][7][8][9] In Korea, specialized critical care teams are relatively lacking compared to other countries. 10 Although, the beneficial effect of neurocritical care on patients in NICU have been reported in the literature, 6,11 those reports were mainly from single-center experience. Moreover, there is no study reported on the outcome of the special care provided by the neurointensivists for patients with ischemic stroke in Korea.…”

Willingness to pay for family education and counselling services provided by critical care advanced practice nurses

“…Thirteen APN specialty areas are authorized by the Medical Service Act in South Korea (Korean Nurses Association, ), and critical care advanced practice nursing is one of these. In South Korea, there is a shortage of board‐certified full‐time intensivists in intensive care units (ICUs) (Lee et al, ), and only 30% of ICUs have at least one full‐time intensivist (Lim, Kwak, Suh, & Koh, . Thus, critical care APNs are expected to play an active role in ICUs (Kim et al, ).…”

Objective Picture of the Nursing Workload in Surgical Intensive Care Unit

“…По данным большинства авторов доля расходов на отделения реанимации составляет не менее 10 % от бюджета больницы и из года в год только увеличивается [1,2]. Огромное значение для медицины критических состояний имеет качество подготовки и обеспеченность кадрами [1,3,4]. При этом специалист здравоохранения, который проводит наибольшее количество времени с больным -это, безусловно, медсестра [4].…”