• Title/Summary/Keyword: Medical service performance

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Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.37-80
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    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

A Study on the Public-Private Partnership in the Emergency Medical System in Korea (한국응급의료서비스 민관파트너십 도입의 타당성에 관한 연구)

  • Kim, Kook-Rae;Kim, Tae-Yun
    • Fire Science and Engineering
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    • v.20 no.2 s.62
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    • pp.31-43
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    • 2006
  • In Korea, the Emergency Medical Service, EMS is provided by Fire Services with 119 EMS and all the public uses the service for free. Although it appears very successful and is respected nationally, structural problem EMS exist and are worsening. First of all, the "free riding effect" becomes increasingly problematic. Some argue that 30% of the demands is not urgent or emergent. The total number of demands is increasing even without the free riding effect. The Current EMS system itself cannot meet the increasing EMS demand. The medical aspect is so poor that the EMS cannot dispatch a medical specialist to the scene. The cardiac arrest resuscitation rate is only $1.24{\sim}9.9%$, compared to 40% in Boston, MA, USA. But due to the regulations and limitations of the Fire Service organization, it is difficult to secure enough EMS resources. To work out these problems, it needs a structural innovation. To secure enough resources and achieve higher medical performance we should invite the medical sector and the private sector into EMS arena by contracting partnerships with Fire Services and charging a reasonable EMS fee. We found through statistical test that any partnership system is more effective than fire-alone system and most countries around the world have partnership system rather than fire-alone system.

Design Factors of Communication Channel for Real Time Service (실시간 서비스를 위한 채널의 설계 요소)

  • Choe, Young-Han;Kim, Jang-Kyung;Jang, Woong;Chin, Byong-Moon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.2 no.3
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    • pp.401-408
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    • 1998
  • Recently there comes out various applications on real time control, audio/video conference, medical image and so on. These applications request certain Quality of Service(QoS) to their underlying communication subsystem. In these cases those communication subsystems should provide real time communication service on their QoS request as well as good performance to maintain best effort traffic. In this paper firstly we briefly look over bandwidth, traffic parameters on point to point network secondly we analyze on real time channel and propose design factors in real time channel protocol for multimedia applications.

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A Study on Performance Perceptions of Hospital Coordinators (병원코디네이터의 직무성과 인식)

  • Cho, Kyoung-Won;Kim, Chang-Hwan
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.25-32
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    • 2009
  • The goal of this paper is to estimate firm performance of hospital coordinators through a survey on employees of medical institutions placed in Busan and Ulsan. The survey for this paper is constituted by 34 questions of 4 groups related to firm performance, qualification requirement, general fact and a certificate of qualification. The survey was carried out from September 12th, 2008 to September 24th 2008 and 388 question sheets collected finally and used for result analysis. In the result analyses related to hospital coordinator and firm performance, we found some principal outcomes such that 88.6% of respondents approved that hospital image by patients and customers is raised, 87.7% of respondents approved that degree of patient's satisfaction on hospital services is raised, and 81.5% of respondents approved that employees recognized importance of services on customers, by hospital coordinators. In the result analysis on differences in firm performance by presence of a certificate of qualification for hospital coordinator, there were meaningful differences in degree of patient's satisfaction, financial performance and degree of employee's recognition on importance of services. From the all of the above results, we verified that establishment and improvement of educational process for hospital coordinator should be performed through researches on degree of patient's and costumer's satisfaction for hospital coordinator, degree of hospital coordinator's satisfaction for the job and surveys of requirements from related industry.

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The Correlation Between The Right To Medical Secrecy And The Employer's Right To Receive Information On The Employee's Health State

  • Yuryk, Olha;Stashkevich, Anatoly;Chornyi, Ruslan;Chorna, Zhanna;Kronivets, Tеtiana;Valakh, Viktoriia
    • International Journal of Computer Science & Network Security
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    • v.21 no.7
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    • pp.103-107
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    • 2021
  • The article analyzes the theoretical aspects of the relationship between the right to medical secrecy and the employer's right to receive information on the employee's state of health, resulting in a more complete description of the implementation of the right to medical secrecy and the employer's right to information on the employee's health state and the possibilities of protecting violated rights. The limits of permissible restrictions on the right to secrecy of health in terms of ensuring the person's performance of their job function have been clarified.

Performance Evaluation of Medical Big Data Analysis based on RHadoop (RHadoop 기반 보건의료 빅데이터 분석의 성능 평가)

  • Ryu, Woo-Seok
    • The Journal of the Korea institute of electronic communication sciences
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    • v.13 no.1
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    • pp.207-212
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    • 2018
  • As a data analysis tool which is becoming popular in the Big Data era, R is rapidly expanding its user range by providing powerful statistical analysis and data visualization functions. Major advantage of R is its functional scalability based on open source, but its scale scalability is limited, resulting in performance degrades in large data processing. RHadoop, one of the extension packages to complement it, can improve data analysis performance as it supports Hadoop platform-based distributed processing of programs written in R. In this paper, we evaluate the validity of RHadoop by evaluating the performance improvement of RHadoop in real medical big data analysis. Performance evaluation of the analysis of the medical history information, which is provided by National Health Insurance Service, using R and RHadoop shows that RHadoop cluster composed of 8 data nodes can improve performance up to 8 times compared with R.

Diagnostic Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography/CT for Chronic Empyema-Associated Malignancy

  • Miju Cheon;Jang Yoo;Seung Hyup Hyun;Kyung Soo Lee;Hojoong Kim;Jhingook Kim;Jae Il Zo;Young Mog Shim;Joon Young Choi
    • Korean Journal of Radiology
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    • v.20 no.8
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    • pp.1293-1299
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    • 2019
  • Objective: The purpose of this study was to evaluate the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for chronic empyema-associated malignancy (CEAM). Materials and Methods: We retrospectively reviewed the 18F-FDG PET/CT images of 33 patients with chronic empyema, and analyzed the following findings: 1) shape of the empyema cavity, 2) presence of fistula, 3) maximum standardized uptake value (SUV) of the empyema cavity, 4) uptake pattern of the empyema cavity, 5) presence of a protruding soft tissue mass within the empyema cavity, and 6) involvement of adjacent structures. Final diagnosis was determined based on histopathology or clinical follow-up for at least 6 months. The abovementioned findings were compared between the 18F-FDG PET/CT images of CEAM and chronic empyema. A receiver operating characteristic (ROC) analysis was also performed. Results: Six lesions were histopathologically proven as malignant; there were three cases of diffuse large B-cell lymphoma, two of squamous cell carcinoma, and one of poorly differentiated carcinoma. Maximum SUV within the empyema cavity (p < 0.001) presence of a protruding soft tissue mass (p = 0.002), and involvement of the adjacent structures (p < 0.001) were significantly different between the CEAM and chronic empyema images. The maximum SUV exhibited the highest diagnostic performance, with the highest specificity (96.3%, 26/27), positive predictive value (85.7%, 6/7), and accuracy (97.0%, 32/33) among all criteria. On ROC analysis, the area under the curve of maximum SUV was 0.994. Conclusion: 18F-FDG PET/CT can be useful for diagnosing CEAM in patients with chronic empyema. The maximum SUV within the empyema cavity is the most accurate 18F-FDG PET/CT diagnostic criterion for CEAM.

Images of Hospital Emergency Medical Technicians Perceived by Emergency Medical Service Providers (Focusing on tertiary medical institutions in Daejeon and Chungcheongnam do) (응급의료종사자가 인식하는 병원 내 응급구조사의 이미지 (대전, 충남 3차의료기관 중심으로))

  • Han, Song-Yi;Bae, Ki-Sook;Kim, Jin-Uk
    • The Journal of the Korea Contents Association
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    • v.12 no.4
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    • pp.373-379
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    • 2012
  • This study surveyed the image of hospital emergency medical technicians with 122 emergency medical service providers (doctors and nurses) working at tertiary medical institutions in Daejeon and Chungcheongnam.do in order to provide basic materials for enhancing the status and professional image of hospital emergency medical technicians. According to the results of this study, the overall image was $3.27{\pm}0.34$, and by its sub.area, professional image was highest and role image was lowest. By item, 'Maintain a friendly relations with doctors' was highest, and 'Arrogant and negligent in job performance' was lowest. In order to enhance their image, hospital emergency medical technicians need to assume a sincere attitude toward patients and colleagues consistently, to strengthen their professionalism, and to carry out their duties and roles faithfully. What is more, the association should take proper measures and to establish the sound image of emergency medical technician as a professional through active campaigns and monitoring using mass media.

The Effect of Chatbot Service Quality on Customer Satisfaction and Continuous Use Intention (챗봇 서비스품질이 고객만족과 지속사용의도에 미치는 영향)

  • Min Jeong KIM
    • Journal of Korea Artificial Intelligence Association
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    • v.2 no.1
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    • pp.15-24
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    • 2024
  • This study is about the effect of chatbot service quality on customer satisfaction and continuous use intention. Data collection was conducted for 13 days from October 23 to November 5, 2023, and a survey was conducted on customers who have used chatbot services. A total of 572 questionnaires were targeted, of which 545 valid data were used for analysis, excluding those that responded insincerely or did not meet the purpose of the study. The analysis results of this study are as follows: First, chatbot service quality partially had a significant effect on satisfaction. Second, customer satisfaction had a significant effect on continuous use intention. Therefore, in order to have a positive impact on continuous use intention, it is necessary to focus on marketing strategies related to chatbot service quality. Also, research focusing on data analysis and performance evaluation is crucial for enhancing chatbot services, necessitating studies that address real-time changes. Through sophisticated data analysis and variable measurement, chatbot services can be effectively improved, leading to enhanced customer satisfaction.

Comparative Analysis of Models for Measuring Consumer Satisfaction in Health Care Organization (병원 고객만족도 측정방법에 대한 비교분석)

  • Lee, Sun-Hee;Choi, Kui-Son;Kang, Myung-Guen;Cho, Woo-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.55-60
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    • 2001
  • Objectives : The SERVQUAL scale is based on gap theory, which suggests the difference between consumers' expectations and the quality of the medical service actually received. However, problems in the implementation of the SERVQUAL scale have been identified by several researchers. Some researchers have proposed a simple performance-based measure (SERVPERF) or au exportation-controlled performance-based measure(Non-Diff) as alternatives to the SERVQUAL scale. On the basis of the theoretical concerns discussed, we examined the capability of each of the three scales(SERVQUAL, Non-Diff, SERVPERF) to explain variations in consumer satisfaction. Methods : Data was gathered from a self-administered questionnaire in a 430 bed hospital. Questionnaires evaluating medical services were distributed to 180 ambulatory patients. A total of 167 usable questionnaires were gathered. The questionnaire was composed of 10 expectation, performance and expectation-controlled performance items. In addition, overall satisfaction and purchase intention were measured. Results : Compared with the SERVQUAL scale, the Non-Diff and SERVPERF scales better explained the observed variations in consumer satisfaction(SERVOQUAL, $R^2=0.29;\;Non-Diff,\;R^2=0.51;\;SERVPERF,\;R^2=0.48$) and purchase intention(SERVQUAL, $R^2=0.22;\;Non-Diff,\;R^2=0.33;\;SERVPERF,\;R^2=0.34$). Conclusion : The maier conclusion from our study is that the Non-Diff and SERVPERF scales are more efficient in assessing consumer satisfaction than the SERVQUAL scale. Therefore we suggest that consumer satisfaction he measured by the Non-Diff or SEVPERF scales.

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