Multilevel Analysis on Factors Influencing Death and Transfer in Inpatient with Severe Injury

Background: This study was conducted to evaluate the individual and community level factors which were influencing the severe injury patients' death and transfer at discharge.Methods: Analysis data is based on Korean National Hospital Discharge In-depth Survey Data released by the Korea Center for Disease Control and Prevention from 2006 to 2008.Study subjects was 11,026 inpatients with of severe injury.For multi-level analysis, socio-demographic characteristics, injury related characteristics, hospitalization related characteristics were used as individual level factors, and socio-environmental characteristics and health care resource characteristics were used as community level factors.Results: As to community level factors affecting mortality of severe injury, the possibility of death was also high in cases of less numbers of surgeons per a population of 100,000 and more number of operation beds.As to community level factors affecting transfer of severe injury, vulnerable areas with higher social deprivation index and low population density had higher possibility of transfer. Conclusion:Both individual level factors and community level factors affected clinical outcomes of treatment for severe injury.In particular, since there happened higher death and transfer of severe injury in socioeconomic and medical vulnerable areas, special efforts for establishing preventive policy and care system for injury in national and area level should be directed toward such areas.