• Health Policy and Management
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• v.22 no.2
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• pp.183-206
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• 2012

Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.1-9
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• 2013

This study intends to identify the characteristics of cancer in-patients and those of cancer patients who defected to other medical institutions based on the summary of hospital discharge information of a university hospital for the purpose of improving work efficiency and maximizing the number of patients. The study used data on cancer patients registered in the database of C University Hospital in Gyeonggi Province for a period of one year between January 1 and December 31. The analysis results suggest that the commonalities of the cancer patients who defected to other medical institutions include no specific job, old age, and hospitalization through emergency room. In conclusion, hospitals need to identify the characteristics of cancer patients classified as patients who are prone to defect and the defection factors through this prediction model.

• Journal of Korea Society of Digital Industry and Information Management
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• v.7 no.1
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• pp.19-29
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• 2011

The u-Healthcare system, a new paradigm, provides healthcare and medical service anytime, anywhere in daily life using wired and wireless networks. It only doesn't reach u-Hospital at home, to manage efficient personal health in fitness space, it is essential to feedback process through measuring and analyzing a personal vital signs. MBAN(Medical Body Area Network) is a core of this technology. MBAN, a new paradigm of the u-Healthcare system, can provide healthcare and medical service anytime, anywhere on real time in daily life using u-sensor networks. In this paper, an ontology-based context-awareness in MBAN proposed system development methodology. Accordingly, ontology-based context awareness system on MBAN to Elderly/severe patients/aged/, with measured respiratory rate/temperature/pulse and vital signs having small variables through u-sensor network in real-time, discovered abnormal signs and emergency situations which may happen to people at sleep or activity, alarmed and connected with members of a family or medical emergency alarm(Emergency Call) and 119 system to avoid sudden accidents for early detection. Therefore, We have proposed that accuracy of biological signal sensing and the confidence of ontology should be inspected.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.19-28
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• 2012

Purpose : The present study was designed to provide basic data for advanced pre-hospital airway management by comparing the insertion time and success rate between laryngeal tube suction II (LTS II) and laryngeal mask airway (LMA) in a manikin. Methods : A total of 32 participants were novice users to both of devices among paramedic students. After taking the introductory lecture and demonstrations, the participants made an attempt to insert the LTS II and LMA to compare the insertion time and success rate. They marked the easiness of insertion of the score ranged from 1 to 10 score scale and preference of the two devices. Results : The insertion time of the LTS II was significantly shorter than that of the LMA (p =.000). There was no significant difference between LTS II and LMA in the success rate. In the easiness of insertion, the score of LTS II $(8.47{\pm}1.41score)$ was significantly higher than that of LMA $(7.19{\pm}1.98score)$(p =.001). The preference of LTS II (75%) was much higher than that of LMA (25%). Conclusion : The manikin study data showed that the LTS II may be a good alternative airway device for providing and maintaining a patent airway.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.165-178
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• 2019

Purpose: This study examined medical college students' perception of euthanasia and analyzed whether there were significant differences in their perceptions based on their grade, religion, and economic situation. Methods: A questionnaire comprising items relating to students' knowledge about euthanasia, their economic situation relationships with patients, and the extent to which euthanasia would be allowed depending on the patient's condition. Results: Results by age and school year revealed there were no statistically significant differences concerning permissible levels of euthanasia. However, differences were found in the permissible levels of euthanasia according to changes in the patients' condition. Conclusion: It can be interpreted that students' personal values and religion had a great effect on the perception of euthanasia than the process of acquiring medical knowledge. The religion or values they have in your life affect your perception of euthanasia more than the process of acquiring and learning medical knowledge. The suffering of patients is the most important priority and it supports euthanasia on the grounds of relieving psychological distress for patients' families and the right of every patient to die gracefully. Nevertheless, considering the possibility of patient survival and euthanasia being used for murder, it is necessary to legislate the use of euthanasia and have the appropriate qualifications for its administration on patients.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.65-78
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• 2020

Purpose: The purpose of the study was to investigate the core competency and educational needs of paramedic students in disaster management. Methods: A self-reported questionnaire was completed by 207 paramedic students between June 1 and October 29, 2017. The study instrument included disaster preparedness (15 items), disaster management core competency (26 items), disaster education needs (26 items). Data were analyzed using t-test, ANOVA, and Duncan's multiple range test using IBM SPSS 24.0. Results: The students reported that only 13% had experienced or witnessed disasters; however, 95.2% would be willing to help in the event of a disaster. Their disaster preparedness was 1.84 points on a 3-point scale. We did see differences in disaster preparedness by background: hospital practice (F=5.352, p=.001); fire-fighting practice (F=8.994, p=.000). The students had a core competency of disaster management at 3.25 points on a 5-point scale with differences depending on major satisfaction (F=3.760, p=.006). The level of student demands for disaster education was 4.29 points. Conclusion: If variety of educational environments are provided for disaster-related learning and training, the core competency of disaster management for paramedic students will improve. The students will be available as disaster management experts in various fields, even after graduation.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.37-48
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• 2021

Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.179-188
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• 2021

Purpose: This study aimed to identify effective cardiopulmonary resuscitation methods by comparing the fatigue of rescuers according to various positions in cardiopulmonary resuscitation situations conducted on beds in hospitals. Methods: An experimental study of students in the department of emergency medical service in H University, G Metropolitan City was conducted in four positions for applying chest pressure on mannequins on beds. Results: As a result of measuring the muscle fatigue of four muscle attachments according to the four positions conducted on the bed, the average was 3.4%, the P was significant at 0.001, and the fatigue difference was confirmed to occur depending on the attachment. An analysis of pressure depth by pose revealed that P1, P2, P3, and P4 have a depth of 58.3, 55.1, 56.4, and 56.3 mm, respectively, with P4 having the deepest depth. Conclusion: Among the various postures of the rescuer during cardiopulmonary resuscitation performed on the bed in the hospital, P1 is thought to be the most tiring, although its associated CPR quality is good.

• Journal of Korean Clinical Health Science
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• v.7 no.1
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• pp.1215-1223
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• 2019

Purpose: This study is to figure out not only the characteristics relating to transfer time of inter-hospital transfer patient which is transferred by a private ambulance, but also factors influencing the transfer time. Methods: In this study, an analysis of 750 patients with high severity levels among those transferred to another hospital by a private ambulance in Busan for whole year of 2017. Results: The results showed that the following factors significantly influence the total inter-hospital transfer time: Ambulance crew (${\beta}=10.525$, p=.001) and patient and carer (${\beta}=37.606$, p<.001) when setting a doctor (selecting a medical institution) as a criterion; availability of the specialized care (${\beta}=12.435$, p=.008) when setting the near distance (reason for selecting a hospital for transfer) as a criterion. The explanatory power of this analysis was R2=0.423, whereas the explanatory power of calibration was R2=0.411. Conclusions: Factors that increase the total inter-hospital transfer time were the ambulance crew, and patient and carer's selecting a medical institution, and the reason for selecting a hospital where enables to offer the specialized care services.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.9-18
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• 2012

Purpose : The purpose of this study was to determine the changes that occur due to the real-time monitoring of paddle pressures which has an important influence on the defibrillation success rate in defibrillation treatment known as the only treatment for cardiac arrest patients with VF. Methods : 40 people participated in the cardiac arrest simulation training and played the role of the defibrillation operator. Investigators measured the pressure of paddle while defibrillating by using instrument which was developed by the investigator. Results : Through real-time monitoring of the paddle pressures of defibrillator by indicator, the front sternum paddle showed a 77.5% success rate and the apex paddle showed a 40% success rate. While the values without monitoring the paddle pressures, the front sternum paddle showed a 51% success rate and the apex paddle showed a 20% success rate. These experiment revealed statistically significant(p <.001) low success rate. Conclusion : The method of monitoring the paddle pressures during defibrillation showed that the paddle can be precisely gripped. The success rate of paddle pressures is significantly correlated with height, weight and grip strength.