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A study on the appointment status of the medical directors and the state of direct medical oversights in private ambulance services

사설이송업체의 지도의사 현황 및 직접의료지도 실태에 관한 연구

  • Received : 2024.06.28
  • Accepted : 2024.08.13
  • Published : 2024.08.31

Abstract

Purpose: This study aimed to assess the appointment status of medical directors and the state of direct medical oversight in private ambulance services, including an analysis of the characteristics of the direct medical oversight requested by private ambulance services. Methods: This study investigated the appointment status of medical directors and direct medical oversight in private ambulance services based on official information disclosed by the National Emergency Medical Center and 17 local governments, along with 8,119 'Dispatch and Treatment Records' collected by a university hospital from 2020 to 2022. Results: Among 129 private ambulance services, 96.12% (124 agencies) had only one medical director, and 43.8% of the medical directors were Emergency Physicians. Over the past three years, the national average direct medical oversight request rate for private ambulance services was 34.68%. In 11.14% of the cases, records stated that EMS providers communicated with the medical director but did not receive direct medical oversight. Conversely, in 36.98% of cases, records incorrectly indicated that EMS providers did not communicate with the medical director but were noted as having received direct medical oversight (p<.05). Most private ambulance services request the direct medical oversight of a single director. Conclusion: This study highlights issues, such as the suitability of the medical director's specialty and inaccuracies in private EMS providers' methods for documenting Dispatch and Treatment Records.

Keywords

References

  1. Korean Law Information Center. Article 44 of the Emergency medical service ACT. Available at: https://www.law.go.kr/법령/응급의료에관한법률/(20260131,20170,20240130)/제44조, 2024. 
  2. National Emergency Medical Center. 2022 Emergency Medical Statistics Yearbook. https://www.e-gen.or.kr/nemc/statistics_annual_report.do, 2023. 
  3. Korea Fire Agency. 2023 119 Emergency Service Statistical Yearbook. https://www.nfa.go.kr/nfa/releaseinformation/statisticalinformation/main/?mode=view&cntId=52, 2023. 
  4. Hong KM. Analysis on patient transfer status of private emergency ambulance services based on prehospital care report. Unpublished master's thesis, Science, Eulji University 2017, Daejeon, Korea 
  5. Han SM, Park JJ, Lee JH, Kok JW. Analysis of patient transport status by private emergency transport companies in Busan. Korean J Emerg Med Ser 2021;25(1):147-58. https://doi.org/10.14408/KJEMS.2021.25.1.147 
  6. Jeong JW, Cho SJ, Lee HR, Kim SK, Jeong JY. Prospective analysis of the emergency patient transport system in the Busan area. Korean Journal of Emergency Medicine 2002;13(1):31-8. 
  7. Kim MS, Lee Gy. Job satisfaction and turnover intention of emergency medical workers working in the emergency patient transport industry. Korean J Emerg Med Ser 2012;16(1):65-80. https://doi.org/10.14408/KJEMS.2012.16.1.065 
  8. Korean Law Information Center. Article 42 of the Enforcement Rules of the Emergency Medical Services ACT. Available at: https://www.law.go.kr/법령/응급의료에관한법률시행규칙/(20240217,00998,20240216)/제42조, 2024. 
  9. Korean Law Information Center. Article 27-4 of the Enforcement Decree of the 119 Rescue and Emergency Services ACT. Available at: https://www.law.go.kr/법령/119구조.구급에관한법률시행령/(20240703,34631,20240702)/제27조의4, 2024. 
  10. Korean Law Information Center. Regulations on the operation of emergency medical services. Available at: https://www.law.go.kr/admRulSc.do?menuId=5&subMenuId=41&tabMenuId=183&query=%EA%B5%AC%EA%B8%89%EC%A7%80%EB%8F%84%EC%9D%98%EC%82%AC%EC%9D%98%20%EC%9A%B4%EC%98%81%EC%97%90%20%EA%B4%80%ED%95%9C%20%EA%B7%9C%EC%A0%95#liBgcolor0, 2024. 
  11. National Medical Center. Establishment of a plan to advance emergency patient transportation service between hospitals. https://www.nmc.or.kr/instlm/bbs/B0000057/view.do?nttId=563&menuNo=800024&pageIndex=1, 2018. 
  12. National Medical Center. Implementation of Certification for Private Emergency Ambulance Services. https://www.e-gen.or.kr/nemc/investigation_view.do?brdctsno=141&upperfixyn=N&currentPageNum=&brdclscd=&searchTarget=ALL&searchKeyword=&searchDatayear=, 2011.
  13. Park SW, Cho SJ, Kim YI, Park MY, Min Mk, Lee SH, Hwang SM. Direct medical guidance for 119 paramedics conducted at the Emergency Medical Information Center. Korean Journal of Emergency Medicine 2011;22(1):9-15. 
  14. American College of Emergency Physicians. The Role of the Physician Medical Director in Emergency Medical Services Leadership. https://www.acep.org/patient-care/policy-statements/the-role-of-the-physician-medical-director-in-emergency-medical-services-leadership, 2023. 
  15. Joo MH. 119 Factors related to paramedics' experience and intention to use direct medical guidance. Doctoral thesis, Chosun University 2015, Gwangju, Korea. 
  16. Park JH. 119 Paramedics' perception of the need for and demand for medical guidance. Korean J Emerg Med Ser 2011;15(3):31-44. https://doi.org/10.14408/KJEMS.2011.15.3.031 
  17. Studnek, J. R., Fernandez, A. R., Margolis, G. S., O'Connor, R. E.. Physician medical oversight in emergency medical services: where are we?. Prehospital Emergency Care 2009;13(1):53-8.  https://doi.org/10.1080/10903120802471964
  18. Lee GW. Clinical review of direct medical guidance in one metropolitan area. Korean Journal of Emergency Medicine 2017;28(4):362-73.