• Title/Summary/Keyword: Emergency Medical Facilities

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A Study on the Characteristics of the Patients Discharged Against Medical Advice (한 대학병원 자의퇴원 환자의 특성 연구 - 퇴원환자 지료정보 DB를 이용하여 -)

  • Hong, Joonhyun;Choi, Kwisook;Lee, Jeonghwa;Lee, Eunmee
    • Quality Improvement in Health Care
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    • v.8 no.2
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    • pp.208-217
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    • 2001
  • Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

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Market in Medical Devices of Blockchain-Based IoT and Recent Cyberattacks

  • Shih-Shuan WANG;Hung-Pu (Hong-fu) CHOU;Aleksander IZEMSKI ;Alexandru DINU;Eugen-Silviu VRAJITORU;Zsolt TOTH;Mircea BOSCOIANU
    • Korean Journal of Artificial Intelligence
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    • v.11 no.2
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    • pp.39-44
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    • 2023
  • The creativity of thesis is that the significance of cyber security challenges in blockchain. The variety of enterprises, including those in the medical market, are the targets of cyberattacks. Hospitals and clinics are only two examples of medical facilities that are easy targets for cybercriminals, along with IoT-based medical devices like pacemakers. Cyberattacks in the medical field not only put patients' lives in danger but also have the potential to expose private and sensitive information. Reviewing and looking at the present and historical flaws and vulnerabilities in the blockchain-based IoT and medical institutions' equipment is crucial as they are sensitive, relevant, and of a medical character. This study aims to investigate recent and current weaknesses in medical equipment, of blockchain-based IoT, and institutions. Medical security systems are becoming increasingly crucial in blockchain-based IoT medical devices and digital adoption more broadly. It is gaining importance as a standalone medical device. Currently the use of software in medical market is growing exponentially and many countries have already set guidelines for quality control. The achievements of the thesis are medical equipment of blockchain-based IoT no longer exist in a vacuum, thanks to technical improvements and the emergence of electronic health records (EHRs). Increased EHR use among providers, as well as the demand for integration and connection technologies to improve clinical workflow, patient care solutions, and overall hospital operations, will fuel significant growth in the blockchain-based IoT market for linked medical devices. The need for blockchain technology and IoT-based medical device to enhance their health IT infrastructure and design and development techniques will only get louder in the future. Blockchain technology will be essential in the future of cybersecurity, because blockchain technology can be significantly improved with the cybersecurity adoption of IoT devices, i.e., via remote monitoring, reducing waiting time for emergency rooms, track assets, etc. This paper sheds the light on the benefits of the blockchain-based IoT market.

Mobile-type blood gas analysis system for data transmission system (이동형 혈액가스분석기의 데이터 전송시스템)

  • Kang Sung-Chul;Kim Gi-Ryon;Jung Dong-Keun;Jeong Do-Un;Jeon Gye-Rok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.1027-1031
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    • 2006
  • Recently, mobile-type analysis system when emergency patient can check his blood condition in the transportation or vessel has being required. Under the present system, it takes lots off-time to know the blood analysis result of patient, so, it may lead to a dangerous situation. But, in this study, analysis time makes to fall down to $1{\sim}min$. to emergency treatment patient more quickly, and you can check the information by wireless PC through Bluetooth base. It is able to measure in about 7minutes from 25minutes of warming-up time in existing facilities by testing temperature peculiarity curve, to operate system without error even minute temperature change by adoption DUAL heating. And Bluetooth base was adopted to reduce power consumption and be able to hospital networking by keeping and sending analyzed data when it needs.

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Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020

  • Lee, Hwajin;Kim, Keon-Yeop;Kim, Jong-Yeon;Kam, Sin;Lee, Kyeong Soo;Lee, Jung Jeung;Hong, Nam Soo;Hwang, Tae-Yoon
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.360-370
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    • 2022
  • Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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A Study of Detainees' Perceptions of the Detention Facilities of the Police Station and their Operation (경찰서 유치장 시설 및 운영에 관한 유치인의 인식연구)

  • Jung, Woo-Yeoul;Park, Dong-Kyun;Kim, Do-Kyun
    • Korean Security Journal
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    • no.13
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    • pp.423-449
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    • 2007
  • This research is to investigate the detention facilities of police stations and their real operations through the perceptions of detainees at police station cells and to present the policy suggestions for them. To fulfill the research, a questionnaire was made out on the basis of 'the Regulation on Detention and Escort for Suspects'. 'the Regulation on a Standard Plan for Detention Facilities' and 'the Regulation on the Lowest Standard to Treat Detainees' ; and detainees at 23 police station cells under the jurisdiction of Kyungbuk Local Police Agency were asked to answer it. Policy suggestions following from the result of the investigation of detainees' perceptions of the detention facilities of the police stations are as follows; Firstly, the structure of police station cells should be arranged in straight lines in order to take their human rights into consideration and more detention facilities are needed to be built in order to separate male, female, handicapped and juvenile inmates. Secondly, shower rooms and washrooms outside the cells should always be open to detainees whenever they need to be used. Thirdly, any detention facilities deficient in fire fighting equipment should have exit doors installed as soon as possible in case of an emergency and provide sufficient fire extinguishers considering the number of detainees and the size of the facilities. Fourthly, the detention facilities should have sufficient windows for ventilation and take necessary measures to obtain natural lighting instead of electric lighting. Fifthly, air conditioners should be equipped properly taking account of the number of detainees and the dimensions of the facilities. Policy suggestions according to the result of the investigation of detainees' perceptions of the operation of detention facilities of police stations are as follows; Firstly, the problem of operating the detention facilities must deal with worn-out facilities and measures to secure the budget should be taken as soon as possible. Secondly, considering that most detained suspects have difficulties in livelihood, daily necessaries must be issued to them. Thirdly, personal belongings deposited by inmates must be properly managed with the same documentation throughout the police station detention facilities. The number of female guards to take exclusive charge of the physical checkups and processing of female detainees should be increased. Also the facilities for handicapped detainees must be expanded, improved and managed properly. Fourthly, except for handcuffs and ropes to bind detainees in the detention facilities, helmets to prevent self-harm must be withdrawn. The budget to improve the quality of meal issued by the government must be urgently secured and the price of private food sent to detainees must be readjusted to be in line with the consumer price. Health and medical care and sanitation for detainees must be substantial, and also sunbathing and outdoor exercises should be allowed to detainees.

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The Relationship Between Fire Service Demand and Project Budget (소방수요와 사업비예산과의 관계)

  • Kim, Jin-Dong;Kim, Hyung-Doo
    • Fire Science and Engineering
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    • v.21 no.3
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    • pp.24-32
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    • 2007
  • The environment of fire service is more uncertain as cities become complicated and new combustibles are used. If fire service's budget is not allocated sufficiently for fire facilities and equipment, fire service's quality and firefighter's safety are affected seriously. Therefore project budget must be increased to prevent fire and disaster effectively. This study investigate the change of fire service demands, the change and priority of fire service budget and project budget. And this study examined the relationship between fire service demand and project budget using correlation and regression analysis. Analysis showed that a number of rescue and emergency medical service were significant variable for project budget.

A Study on School Health Promotion Services (학교보건사업을 통한 건강증진 사업에 대한 연구)

  • Nam, Chul Hyun
    • Journal of the Korean Society of School Health
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    • v.10 no.2
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    • pp.193-211
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    • 1997
  • The study was designed to gain necessary basic data in order to grasp the health knowledge, attitude, and practice level of students and teachers of elementary, middle and high schools. This study was conducted through interviews of 3,400 students and 1,022 teachers attending 14 different schools large, middle and small cities and rural towns during a period of nine months (from Oct. 2 1995 to Jun. 30 1996). By the results of this study, the recommendations can be summarized as follows: 1. A school health development committee should be established of 10 members: school health related teachers (physical trainers, nurses, and teachers in charge of health), parents, persons related to health administration, local medical doctors, and student reprensentatives in order to support and immplement school health development plans. 2. Like advanced countries, a health class of 2~4 hours should beplaced in middle and high schools. A nurse majoring in health from a university should be the teacher. 3. A curriculum of health should contain the following: education on health, sex, alcohol, tabacco, the misuse of the drugs, the structure and function of human body, the growth of the body, mental health, safety and emergency care, the prevention of disease, proper eating habits and nutrition, daily health life, family health education, society health, community health, environmental pollution and individual responsibility. 4. Create a school health promotion center, with a nurse's office, and a sports center which has health machines (bars, aerobics, training, twist machine, belt massage, running machine, bench press, chest waist, hack hip extension machine) as well as a physical strength measuring machine (muscular strength, alertness, flexibility, endurance, lung functions and so on), so that the teaching staff and students can use them and train their bodies. 5. Through a refresher education program, urge teachers to understand school health promotion services. 6. Regulate a standard and establish a system of monitoring the physical enviroment of the school (the height of desks and chairs, illumination facilities, ventilation facilities, safe drinking water). 7. Create a check list of health to evaluate improvement.

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A study on the space and requirements of evaluation and certification criteria for psychiatric institutions (정신의료기관 평가와 인증 기준의 공간 및 요구사항 연구)

  • Lee, Eun Jin;Lee, Seung Ji
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.1
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    • pp.31-39
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    • 2022
  • Purpose: The study aimed to extract the space mentioned in the criteria for evaluation and certification of psychiatric institutions in which the most specific standards for medical services of psychiatric institutions are prepared, and to organize and analyze the requirements. Method: The implied space is derived by analyzing the evaluation and certification criteria. The derived space is re-classified by departments of the hospital, and the requirements are organized and analyzed. Results: First, a total of 41 spaces were derived. The derived spaces can be considered as spaces to be treated as important in psychiatric institutions. Second, as a result of reclassifying the derived space by department, 10 spaced for the hospital as a whole, 10 for wards, 12 for central/outpatient departments, 5 for pharmaceutical departments, 2 for catering facilities, and 2 for facilities. Third, if organized by psychiatric institution, there is a total of 40 spaces for psychiatric hospitals according to certification criteria, and according to evaluation criteria, there is 38 spaces for psychiatric hospitals and departments and 19 spaces for the clinics. The difference between the certification and evaluation criteria of psychiatric hospitals is insignificant. In order to promote the qualitative improvement of psychiatric institutions, it is necessary to gradually strengthen from the certification criteria. Fourth, the requirements reflecting the characteristics of a psychiatric institution were very limited to emergency exits and treatment rooms. It is necessary to prepare the space requirements for other rooms in consideration of the behavior of the mentally ill. Implications: The derived spaces and requirements can serve as practical reference materials for practitioners preparing to receive certification and evaluation of psychiatric institutions. In addition, it has meaning as a basic data for estimating the level of space and requirements of psychiatric institutions that are currently required in Korea.

Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model

  • Kang, Jung Hun;Jung, Chang Yoon;Park, Ki-Soo;Huh, Jung Sik;Oh, Sung Yong;Kwon, Jung Hye
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.226-234
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    • 2021
  • Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.