요양병원 환자안전사고 분석

Analysis of patient safety incidents in long-term care hospitals: Utilization of recent 5-year Korea patient safety statistics

본 연구는 의료기관평가인증원이 발표한 환자안전통계자료를 활용하여 국내 요양병원에서 발생한 환자안전사고의 빈도, 위해수준 및 관련요인을 파악하여 추후 위해발생의 위험을 감소시키기 위한 시스템 개선전략 개발의 기초자료를 제공하기 위해 수행되었다. 2018~2022년까지 요양병원에서 발생한 환자안전사고 중에서 10,117건을 대상으로 병원관련 특성 및 환자관련 특성에 따른 환자안전사고의 위해정도의 차이는 χ2를 통한 교차분석을 하였고, 환자안전사고의 위해발생에 영향을 미치는 요인은 이항로지스틱회귀분석을 실시하였다. 위해발생위험은 500병상 이상에 비해 200병상 미만은 약 1.2배, 200~500병상 미만인 경우는 약 1.4배 높았고 투약오류에 비해 상해인 경우 약 74.8배, 자살 · 자해는 약 24.9배, 식사는 약 10.7배, 낙상은 약 7.6배 높았다. 200병상 미만의 요양병원은 법적인 사각지대에 놓여있고, 환자안전사고의 위해발생위험도가 높기때문에 환자안전관리법제화가 필요하며 상해는 투약오류에 비해 위해발생위험이 매우 높기때문에 요양병원의 상해발생원인을 구체적으로 파악하여 예방대책을 마련하는 것이 시급할 것으로 생각된다.

This study aimed to analyze the frequency, severity, and associated factors of patient safety incidents in long-term care hospitals in Korea, utilizing patient safety statistics. The objective was to provide foundational data for the development of system improvement strategies aimed at reducing the risk of harm occurrence in the future. From 2018 to 2022, a total of 10,117 patient safety incidents occurring in long-term care hospitals were analyzed. Cross-tabulation using chi-square tests was conducted to examine differences in the severity of patient safety incidents based on hospital-related characteristics and patient-related characteristics. Additionally, binary logistic regression analysis was performed to identify factors influencing the occurrence of harm in patient safety incidents. The risk of harm occurrence was approximately 1.2 times higher in hospitals with fewer than 200 beds and about 1.4 times higher in hospitals with 200-500 beds compared to those with over 500 beds. Furthermore, compared to medication errors, the risk of harm occurrence was approximately 74.8 times higher for injuries, 24.9 times higher for suicide·self-harm incidents, 10.7 times higher for meal-related incidents, and 7.6 times higher for falls. Given that long-term care hospitals with fewer than 200 beds are in a legal gray area and have a higher risk of harm occurrence in patient safety incidents, legislation for patient safety management is necessary. Additionally, since injuries pose a significantly higher risk of harm occurrence compared to medication errors, it is imperative to accurately identify the causes of injuries in long-term care hospitals and devise prevention measures.