Prioritizing Emergency Medical Conditions for Health Policy Using a Stepwise Treatable-Death Framework: A Nationwide Analysis in Korea, 2018–2022

Background/Objectives: Limited emergency-care resources require priorities based not only on mortality rates or death counts but also on the potential mortality reduction under explicit targets. We applied the age- and sex-standardized domestic short- and mid-term components of a stepwise treatable-death framework across severe emergency conditions in Korea.

Methods

This retrospective nationwide study used NEDIS aggregate data from 16 regions during 2018–2022. The 20 conditions with the highest numbers of in-hospital deaths were represented as 17 groups by replacing sepsis (A41), bacterial pneumonia (J15), pneumonia of unspecified organism (J18), and pneumonitis due to solids and liquids (J69) with an extended-sepsis composite. Treatable deaths were the positive difference between observed and target-based expected deaths. National rates in 10-year age-group and sex strata were applied to regional distributions. The short-term target assumed that regions with an age- and sex-standardized mortality ratio (SMR) above 1.0 achieved the national reference level (SMR = 1.0), whereas the mid-term target assumed that all regions achieved the lowest regional SMR for the corresponding condition and year. Five-year cumulative estimates were the primary outcome measure.