Ann Surg Treat Res.  2023 Feb;104(2):61-70. 10.4174/astr.2023.104.2.61.

Understanding Regional Trauma Centers and managing a trauma care system in South Korea: a systematic review

Affiliations
  • 1Research Institute of Health Insurance Review and Assessment, Health Insurance Review and Assessment Service, Wonju, Korea
  • 2Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea

Abstract

The Korean government initiated a plan to designate and establish Regional Trauma Centers to reduce the preventable trauma death rate to <20% so as to be on par with advanced countries by 2020. This initiative was undertaken because the reported preventable trauma death rate was close to 40% in South Korea from 1997 to 2009. This review aimed to provide an overview of these Regional Trauma Centers and discuss further development of the trauma care system to assess its performance. As of September 2021, 15 Regional Trauma Centers had been established through a metropolitan-based designation process. Each center has been equipped with Level-I facilities. These Regional Trauma Centers have had 2 positive effects; namely, an increase in the number of severely injured patients attending these centers and a decrease in the national preventable trauma death rate from 30.5% in 2015 to 19.9% in 2017. The establishment of Regional Trauma Centers can lead to improved performance, maximal efficiency, and reduction of preventable deaths in trauma patients. They can also play a key role in prehospital triage and transportation in the trauma care system.

Keyword

Delivery of health care; Injuries; Mortality; Republic of Korea; Trauma centers

Figure

  • Fig. 1 Designated Regional Trauma Centers.


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Reference

1. World Health Organization (WHO). Guidelines for trauma quality improvement programme [Internet]. WHO Press;2009. cited 2022 Jul 12. Available from: https://apps.who.int/iris/handle/10665/4406 .
2. Statistics Korea. Annual report on cause of death statistics [Internet]. Statistics Korea;2019. updated 2020 Sep 20. cited 2022 Jul 12. Available from: https://kostat.go.kr/portal/korea/kor_nw/1/6/2/index.board?bmode=read&bSeq=&aSeq=385219&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt= .
3. Statistics Research Institute. Korean social trends 2018 [Internet]. Statistics Korea: 2018;updated 2018 Dec 14. cited 2022 Jul 12. Available from: http://kostat.go.kr/sri/srikor/srikor_pbl/7/2/index.board?bmode=read&bSeq=&aSeq=372068&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt= .
4. Park DJ, Park CY, Cho HM, Lee KH, Han HS. Current status and future prospects of trauma centers in Korea. J Korean Med Assoc. 2017; 60:530–532.
5. Ministry of Health and Welfare (MOHW). Press release: The nationwide ‘preventable trauma mortality rate’ significantly improved from 30.5% to 19.9% [Internet]. MOHW;2019. 12. 11. cited 2022 Jul 12. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=351836 .
6. Kwon J, Lee JH, Hwang K, Heo Y, Cho HJ, Lee JC, et al. Systematic preventable trauma death rate survey to establish the region-based inclusive trauma system in a representative province of Korea. J Korean Med Sci. 2020; 35:e417. PMID: 33372420.
7. Yu B, Lee G, Lee MA, Choi K, Hyun S, Jeon Y, et al. Trauma volume and performance of a regional trauma center in Korea: initial 5-year analysis. J Trauma Inj. 2020; 33:31–37.
8. Christoffel T, Callagher SS. Injury prevention and public health: practical knowledge, skills, and strategies. 2nd ed. Johns and Bartlett Publisher;2006.
9. Yoon HD. Background and progress of regional trauma center development. J Korean Med Assoc. 2016; 59:919–922.
10. Jung K, Lee JC, Kim J. Injury severity scoring system for trauma patients and trauma outcomes research in Korea. J Acute Care Surg. 2016; 6:11–17.
11. Jung K, Kim I, Park SK, Cho H, Park CY, Yun JH, et al. Preventable trauma death rate after establishing a national trauma system in Korea. J Korean Med Sci. 2019; 34:e65. PMID: 30833882.
12. Shin YS. 30 years of Korean Health Insurance: its success, failure, and future directions. J Korean Med Assoc. 2007; 50:568–571.
13. Choi E, Kim J, Lee W. Health care system in Korea. Korea Institute for Health and Social Affairs;1998.
14. Cho JK. An improvement plan for health care delivery system. Health Welf Policy Forum. 2010; 11:6–15.
15. Im J. Improved status of EMS schedule and its issues. HIRA Policy Brief. 2020; 14:26–36.
16. Martin RS, Meredith JW. Management of acute trauma. Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston textbook of surgery: the biological basis of modern surgical practice. 20th ed. Elsevier, Inc.;2017. p. 409–448.
17. Committee on Trauma, American College of Surgeons. Resources for optimal care of injured patients. American College of Surgeons;2014.
18. David BH, Coimbra R, Winchell RJ. Management of acute trauma. Townsend CM, Sabiston DC, editors. Sabiston textbook of surgery: the biological basis of modern surgical practice. 16th ed. W.B. Saunders;2001. p. 311–344.
19. Oh YH. Current problems of EMS and a plan for its improvement in Korea. KIHASA Issue Focus. 2011; (105):1–8.
20. Seo EW, Im J. A review of quality management and improvement of trauma fee schedule in regional trauma center. Health Policy Manag. 2021; 31:399–408.
21. Yoo IS. The current status of affairs in emergency care system. HIRA Policy Brief. 2015; 9:17–30.
22. Kim Y, Shin SD, Park JH, Lee TJ, Park CB, Lee YT, et al. A study on building and operational modeling of Korean regional trauma center. Ministry of Health and Welfare;2010.
23. Ministry of Health and Welfare (MOHW). A handbook of a regional trauma center project. MOHW;2013.
24. Park JM. Outcomes of the support services for the establishment of regional level 1 trauma centers. J Korean Med Assoc. 2016; 59:923–930.
25. Kim Y, Kang DW, Ro YS, Park SB, Park JH, Park CB, et al. A study on the construction of trauma medical service system. Ministry of Health and Welfare;2011.
26. Hendrikson H. The right patient, the right place, the right time: a look at trauma and emergency medical services policy in the States. National Conference of State Legislatures;2012.
27. Institute of Medicine. Emergency medical services at the crossroads. The National Academies Press;2007.
28. Ministry of Health and Welfare (MOHW). Press release: The National Assembly passes the revised Emergency Medical Service Act [Internet]. MOHW;2008. 08. 10. revised 2012 Aug 16. cited 2022 Jul 12. Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=817&CONT_SEQ=202891 .
29. Baek HS, Lee JH, Kim LS, Park HS, Park SS. EMS fund, it is functioning or fumbling? J Korean Clin Health Sci. 2013; 1:35–45.
30. Ministry of Health and Welfare. Administrative guidelines for regional trauma center. National Emergency Medical Center;2020.
31. Ministry of Health and Welfare. 2021 Guidelines for quality assessment of regional trauma center. National Emergency Medical Center;2020.
32. Ministry of Health and Welfare. 2019 Annual report on Korea trauma data bank. National Emergency Medical Center;2020.
33. Shon C, You M. Evaluation of health policy governance in the introduction of the new DRG-based hospital payment system from interviews with policy elites in South Korea. Int J Environ Res Public Health. 2020; 17:3757. PMID: 32466432.
34. Heo YJ, Im J, Lee TH, Seo EW, Yoon SY, Kim SW, et al. A study on building operation standardization for regional trauma centers. Ministry of Health and Welfare;2019.
35. Health Insurance Review and Assessment Service (HIRA). A handbook of medical benefit cost in National Health Insurance. HIRA;2018.
36. Health Insurance Review and Assessment Service (HIRA). A handbook of medical care benefit cost in National Health Insurance. HIRA;2021.
37. Hwang K, Kwon J, Cho J, Heo Y, Lee JC, Jung K. Implementation of trauma center and massive transfusion protocol improves outcomes for major trauma patients: a study at a single institution in Korea. World J Surg. 2018; 42:2067–2075. PMID: 29290073.
38. Kim Y, Park SK, Jung K, Cho HM, Park CY, Yoon JH, et al. Evaluation of preventable trauma death rate and development of operational management plan for regional trauma center. Ministry of Health and Welfare;2017.
39. Kim Y, Jung K, Kwon J, Heo Y, Moon JH, Hwang K, et al. A study on evaluation of preventable trauma death rate. Ministry of Health and Welfare;2019.
40. Lee M, Lee G, Lee J, Yu B. Surgical volumes in a regional trauma center: is it enough? J Acute Care Surg. 2020; 10:10–12.
41. Richardson JD, Miller FB. Will future surgeons be interested in trauma care? Results of a resident survey. J Trauma. 1992; 32:229–235. PMID: 1740807.
42. Moore HB, Moore PK, Grant AR, Tello TL, Knudson MM, Kornblith LZ, et al. Future of acute care surgery: a perspective from the next generation. J Trauma Acute Care Surg. 2012; 72:94–99. PMID: 22310121.
43. Drake SA, Wolf DA, Meininger JC, Cron SG, Reynold T, Wade CE, et al. Methodology to reliably measure preventable trauma death rate. Trauma Surg Acute Care Open. 2017; 2:e000106. PMID: 29766101.
44. Committee on Trauma Leadership, American College of Surgeons. National Trauma Data Bank 2016 Annual Report. American College of Surgeons;2016.
45. Seo GJ, Yoo IS, Lee KH, Heo T, Lee JE, Hong ES, et al. Improvement of prehospital emergency care. Ministry of Health and Welfare;2011.
46. National Health Service (NHS). Regional networks for major trauma: NHS Clinical Advisory Groups report, September 2010. NHS;2010.
47. Committee on Trauma, American College of Surgeons. Regional trauma systems: optimal elements, integration, and assessment systems consultation guide. American College of Surgeons;2008.
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