• Health Policy and Management
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• v.30 no.3
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• pp.399-408
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• 2020

Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km² area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.884-892
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• 1997

Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

• The Korean Journal of Emergency Medical Services
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• v.23 no.2
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• pp.19-31
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• 2019

Purpose: This study aimed to investigate disaster preparedness competence and disaster response competence of paramedics working in emergency medical centers operating a disaster medical assistance teams. Methods: Data of 174 emergency medical technician(EMT)-paramedics were collected from July 15 to August 14, 2018 at regional and local emergency medical centers that operate disaster medical assistant team. Analysis of the data was carried out with IBM SPSS statistics 24.0 software (IBM, Armonk, NY, USA). Results: The mean disaster preparedness competence score was $3.57{\pm}0.63$ (out of five). Participants' disaster preparedness competence significantly differed according to type of emergency medical center (p<.000), disaster education experience (p<.000), and education frequency (p=.001). The mean disaster response competence score was $4.09{\pm}0.57$ (out of five). Participants' disaster response competence significantly differed according to disaster education experience (p<.000) and medical assistance experience (p=.045). Conclusion: Emergency medical technician-paramedics without disaster training should first be provided with this training. Further, it is important for EMT-paramedics to know their disaster preparedness and response capacities and strengthen their shortcomings. It is also important to develop education and training programs that properly equip EMT-paramedics with practical competencies.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.55-64
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• 2003

The purposes of this study which was conducted by applying three projection formulae to the data from admission quota for paramedic of the Ministry of Education & Human Resources Development the number of ambulances the number of emergency medical centers of the Ministry of Health & Welfare and rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board were to find out demand and supply of paramedic from 2002 to 2045 and to expand scope of practice of paramedic in Korea. The conclusions from this study were summarized as follows; (1) The simple formulae derived from the projection formula of the Economic Planning Board were applied under the present Emergency Medical Services Act including qualifying over 3-years experienced EMT-Basic for paramedic examinee, stationing paramedic or EMT-Basic or physician or nurse per ambulance, stationing paramedic or EMT-Basic per emergency medical center and under the amended Emergency Medical Services Act including qualifying only paramedic graduate for paramedic examinee, stationing 4.5 paramedics per ambulance, stationing 10 to 2 paramedics per emergency medical center. (2) It was estimated that on the American basis of 5.6 EMTs per 10,000 in 1996, the number of paramedics under the present act will reach the basis before 2020, the number of paramedics under the amended act will reach the basis about 2040. (3) It was estimated that on the basis of 22,000 paramedics demanded from the number of ambulances, the number of emergency medical centers in 2001, the number of paramedics under the present act will reach the basis before 2015, the number of paramedics under the amended act will reach the basis about 2030. (4) There was relationship between requirements for emergency medical centers scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic including EMD, instructor, teacher of safety. (5) This study which includes only expanded scope of practice of paramedic and projection for paramedic in the act needs complementary studies such as decision-making process in health manpower policy and so on.

• The Korean Journal of Emergency Medical Services
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• v.22 no.2
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• pp.51-65
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• 2018

Purpose: The purpose of this study was to investigate experiences of violence with patients or family members by paramedics working at emergency rooms. Methods: A questionnaire was administered from June 1 to 31, 2017 to 225 paramedics working at 27 emergency medical centers. The collected data were analyzed with SPSS statistics ver 24.0 program. Results: Within the past year, 208(92.9%) of 224 participants experienced violence among whom 202(90.2%) experienced verbal abuse, 193(86.2%) experienced physical threat, 89(39.7%) experienced physical violence, and 52(23.2%) experienced sexual violence. The level of violence response depending on the overlapping experience of violence type showed significant difference from emotional response (p= .001), social response (p= .001), physical response (p= .004), and overall violence response (p= .001). Conclusion: In conclusion, paramedics are frequently exposed to violence in the emergency rooms, of which they mostly experience verbal abuse. In addition, because the reporting system in the event of violence and the coping process are not well-informed, paramedics are unable to sufficiently utilize the reporting system and programs established within the institution. Therefore, the support of the legal system is needed to create a safe working environment for the medical staff who work in the emergency medical centers.

• The Journal of the Korea Contents Association
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• v.9 no.6
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• pp.275-288
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• 2009

The research has been investigated to enhance job recognition and satisfaction in Emergency medical information center and to induce some positive suggestions to develop emergency medical information centers in Korea. As a result, the findings found that the tasks which the experts felt are most easily ones are the guidance, counseling, and advice of a patient, while the most difficult tasks are the advice on the first-aid treatment and the guidance of the hospitals. The research has found the findings that most employees feel that they perform their jobs quite well including the guidance and consultation of first-aide patients. They also feel that they are under stress in consulting patients, and in making decisions to visit emergency centers and to observe the patients in limited information without seeing patients in person. They are concerned about the identity of emergency information centers, feeling that it is difficult to construct smoothly the collaboration of such agencies as the administrative, emergency medical centers, 119 resue teams to treat first aide treatments, to provide transportation information, and hospital guidance.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.2
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• pp.176-186
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• 2014

Purpose: The purpose of this study was to analyze factors affecting fall prevention activities of emergency room (ER) nurses based on their health belief factors (perceived susceptibility, perceived benefits, perceived severity, perceived barriers, and cues to action). Methods: The study design was a descriptive survey using questionnaires which were given to 127 emergency room nurses from two regional emergency medical centers, four local emergency medical centers, and two local emergency medical facilities. Data were analyzed using descriptive analysis, t-test, one-way ANOVA with LSD test, Pearson correlation, and multiple regressions. Results: ER nurses' fall prevention activities had a mean of $3.78{\pm}0.50$. Eight individual characteristics and health belief factors accounted for 30.8% of the fall prevention activities. Fall prevention activities were found to be positively affected by emergency medical facilities, perceived benefits, and cues to action and negatively affected by factors, such as ER career and perceived severity. Conclusion: The results indicate that it is necessary to formulate a plan for enhancing perceived benefits and cues to action to improve fall prevention activities. In addition, fall prevention activities should be encouraged for ER nurses who have worked in local medical institutions for less than 1 year or more than 5 years.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.145-156
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• 2021

Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

• Journal of the Korean Medical Association
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• v.61 no.12
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• pp.710-714
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• 2018

A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.116-123
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• 2016

Purpose: To develop an inclusive and sustainable trauma system as the assessment of burden of injuries is very much important. The purpose of this study was to evaluate the estimates and characteristics of abdominal traumatic injuries. Methods: The data were extracted from the National Emergency Department Information System. Based on Korean Standard Classification for Disease 6th version, which is the Korean version of International Classification of Disease 10th revision, abdominal injuries were identified and abdominal surgeries were evaluated with electronic data interchange codes. Demographic factors, numbers of surgeries and clinical outcomes were also investigated. Results: From 2011 to 2014, about 24,696 patients with abdominal trauma were admitted to the hospitals annually in South Korea. The number of patients who were admitted to regional and local emergency medical centers was 8,622 (34.91%) and 15,564(63.02%), respectively. Based on National Emergency Department Information System, liver was identified as the most commonly injured abdominal solid organ (39.50%, 9,754/24,696, followed by spleen (17.57%, 4,338/24,696) and kidney (12.94%, 3,195/24,696). Conclusion: This study shows that the demand for abdominal trauma care is considerable in South Korea and most of the patients with abdominal trauma were admitted to regional or local emergency centers. The results of this study can be used as good source of information for staffs to ensure proper delivery of abdominal trauma care in trauma centers nationally.