• 한국임상보건과학회지
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• 제7권1호
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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.

• 한국응급구조학회지
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• 제16권1호
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• pp.65-80
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• 2012

Purpose: The objective of this study was to assess the job satisfaction and turnover intention of the emergency medical technicians (EMT) in the private ambulance service, to examine their job satisfaction and turnover intention, and to provide the solution for the management of the private ambulance service. Methods: The survey was conducted with 121 EMTs (73 paramedics, 36 basic EMTs and 12 nurses) in the private ambulance service in Korea from September 15 to October 14, 2011. In the reliability of the questionnaire, Cronbach's ${\alpha}$ was 0.790 for job satisfaction and 0.796 for turnover intention. Using SPSS 18.0, we obtained Cronbach's ${\alpha}$, frequencies, percentages, means, and standard deviations, and performed independent t-tests, ANOVA, and Pearson's correlation analysis. Results: 1) The mean score with regard to job satisfaction was 2.94 and that of their turnover intention was 4.23. In the area of job satisfaction, the mean score of the job demand area was 4.23; 3.97 for the job itself; 3.07 for the area of interaction; 2.98 for the area of autonomy: 2.67 for the organizational demand area; 2.67 for working conditions area; and 1.73 for the wage area. 2) Statistically significant difference was observed in job satisfaction according to age (F=3.819, p=.006), wages (t=-4.640, p=.000), terms of incumbency (F=3.868, p=.011), and in turnover intention it was according to sex (t=-1.995 p=.048), age (F=9.611, p=.000), education levels (F=6.974, p=.002), marital status (t=4.393, p=.000), wages (t=5.515, p=.000), license types (F=8.481, p=.001), and terms of incumbency ( F=14.115, p=.000). 3) The job satisfaction and the turnover intention had a negative correlation to each other (r=-.56, p<.000) in general, and in the sub-7 areas of job satisfaction, the correlation with turnover intention was high in order of the wage area (r=-.61, p=.000), working conditions area (r=-.52, p=.000), the area of autonomy (r=-.49, p=.000), the area of interaction (r=-.45, p=.000), the organizational demand area (r=-.40, p=.000), the job itself (r=-.24, p=.007) and the job demand area (r=-.24, p=.009). Conclusion: The government must take the charge of lowering the turnover intention among paramedics in the private ambulance service by providing the advantage in wages and fringe benefits. Ultimately, this would bring an improvement in the quality of medical emergency services to hospitals especially in the area of patient transfer and transportation.

• 한국융합학회논문지
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• 제8권8호
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• pp.127-136
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• 2017

본 연구의 목적은 민간 응급환자이송업체에 종사하는 구급차 운전자의 기본 응급처치 인식을 알기 위함이다. 2013년 2월 20일부터 4월 1일까지 서울, 경기, 인천의 민간 응급환자이송업체에 근무하는 구급차 운전자를 대상으로 조사한 설문지 중 181부를 분석하였다. 설문 구성은 기본소생술생술에 관련된 기도 관련문항(A)-3문항, 호흡 관련문항(B)-9문항, 순환관련문항(C)-4문항, 의식 확인 관련문항(D)-4문항, 감염관리 관련-3문항 등으로 총 23문항으로 구성하였다. 감염관리 인식은 87%에서 알고 있었으며, 기도, 호흡, 의식에 대한 인식은 60%였다. 응급처치는 23점 만점에 15.20점, 의식 확인은 4점 만점에 2.55점, 기도관리는 3점 만점에 2.08점, 호흡은 9점 만점에 5.35점, 순환은 4점 만점에 2.56점이었다. 민간 구급차 운전자의 질 향상을 위해서는 지속적인 교육프로그램 확대가 중요하다. 이 연구는 응급의료체계에서 민간구급차 서비스의 양적, 질적 향상에 도움이 될 것이다.

• 한국응급구조학회지
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• 제25권1호
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• pp.147-158
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• 2021

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

• 한국화재소방학회논문지
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• 제33권6호
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• pp.152-158
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• 2019

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008-2016년 연간 데이터(Version 1.5)를 이용해 임신, 출산, 산후기 여성의 구급 이송 서비스 이용 특성을 분석하였다. 분석 결과를 요약하면, 첫째, 임신, 출산 및 산후기 여성의 119 구급차, 민간 구급차 등 구급 이송 서비스 이용률은 12.0%로 전체 구급 이송 서비스 이용률 18.9%보다 상대적으로 낮았다. 둘째, 임신, 출산 및 산후기 여성의 응급에서 분만이 38.7%로 가장 큰 비중을 차지하였으며, 진통 및 분만의 합병증이 20.0%, 유산된 임신이 17.3% 등의 순으로 나타났다. 셋째, 임신, 출산 및 산후기 여성의 구급 이송 서비스 이용 특성 중 연 평균 가구소득, 응급실 도착 소요시간, 응급실 도착 지연 인식 등에서 구급 이송 서비스의 이용자 집단과 비이용자 집단 사이에 통계적으로 유의한 차이가 나타났다. 따라서 저출산과 고령 산모로 인하여 분만 취약지가 늘어날수록 임신, 출산, 산후기 여성을 위한 사회안전망으로서 구급 이송 서비스의 양적 확대와 질적 제고는 더욱 시급한 과제가 될 것이다.

• 성인간호학회지
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• 제12권3호
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• pp.323-333
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• 2000

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

• 대한응급의학회지
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• 제29권5호
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

• 한국응급구조학회지
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• 제8권1호
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• pp.199-210
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• 2004

Since the 119 fire department was legally permitted to serve in Emergency Medical Service(EMS)Operation of emergency patients in 1983, 119 EMS operation in general has made a big progress in serving the needs for emergency patients. Currently EMS operation is carried out by 119 EMS unit, private ambulance Co.,etc. But due to the public recognition and volunteers, 119 EMS operation carries the major share of the service. This observation is not surprising in that such a trends occured in Japan 20 years ago. This paper compared the 119 EMS operation conducted by the fire department in Korea with that of Japan in order to draw some inferences from the comparison. The results of the study compared to Japan were as follows: 1. Japan was higher 1.5 times in the number of EMS units per population(100,000), 1.1 times in the number of patient transports per unit. 2. Japan was higher 4.54 times in the number of the 119 EMS personnel per population(100,000), 30.6 times in that per square killometers, 30.6 times per 119 EMS unit, in per ambulance 2.48times. 3. Japan was higher 1.83 times in the number of ambulance per population(100,000), 1.26 times in that per square killo meters. 4. Japan was higher 1.7 times in the number of transport patients per population (100,000), but Korea was higher 2.68 times in the transport patients per EMS personal. 5. Compared to Japan, there was no emergency care related to ALS, for example, such as administering dugs orally and intravenously, interpreting elctrocardiograms, performing endotracheal tube or LMA insertion, using monitors and other complex equipments in Korea.

• 한국응급구조학회지
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• 제12권1호
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• pp.5-15
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• 2008

Purpose : Centering on users(patients) who are offered the patient transport service by the emergency medical service system in our country, the use and satisfaction are analyzed with the transport service in 119 Emergency Medical Service System and Private transport agent. Results : 1. As for personnel in ambulance cars, 119 emergency staff showed a higher boarding rate of the first-class emergency medical technicians than private transportation centers : 48.4% and 17.7%, respectively. 2. Private transportation centers showed higher user satisfaction with transportation service than 119 emergency staff, which was not statistically significant. 3. As for the case that needs to receive the transport service in the future, the ratio with the will to use 119 Emergency Medical Service System(70.9%) was indicated to be much higher than the ratio of the private transport agent(29.1%). Suggestions : First, Centers transporting first-aid patients should essentially secure a sufficient number of first-class emergency medical technicians as professional emergency medical staff to reinforce qualitative improvement in emergency medical service. Second, It is necessary to establish a systematic monitoring system and develop educational programs in order to enhance satisfaction with the use of 119 emergency staff. Third, the government or the local government needs to positively support and guide the private transport agent, which is in charge of the public medical service.

• 한국화재소방학회논문지
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• 제28권3호
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• pp.80-86
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• 2014

본 연구에서는 한국보건사회연구원과 국민건강보험공단(2013)의 한국의료패널 2009년 데이터를 이용해 응급환자 이송 서비스의 이용과 관련된 사회경제적 임상적 특성을 조사하고, 예측 인자를 분석하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등 응급환자 이송 수단을 이용한 경우가 자가용, 택시, 도보 등 응급환자 이송 수단을 이용하지 않은 경우보다 많았다. 둘째, 개인 및 가구 특성 변수 중 연령, 교육 수준, 세대 구성, 주거 형태, 월 평균 가구 소득, 가구주와의 관계 등에서, 응급 상황 특성 변수 중 의료 보장 형태, 장애 유무, 만성질환 유무, 응급실 방문 이유, 응급실 이용 후 조치 등에서 응급환자 이송 수단을 이용한 경우와 이용하지 않은 경우에 통계적으로 유의한 차이를 나타냈다. 셋째, 개인 및 가구 특성 변수 중에서는 연령과 월 평균 가구 소득, 응급 상황 특성 변수 중에서는 장애 유무, 응급실 방문 이유, 응급실 이용 후 조치 등이 응급환자 이송 서비스의 이용에 통계적으로 유의한 예측 인자로 나타났다. 따라서 병원 전 응급환자 이송 단계에서 응급 처치의 적절성 제고와 함께 응급환자 이송 서비스의 이용 특성과 예측 인자를 감안한 효과적 대응이 필요하다.