Purpose: The purpose of the study was to compare the ability of college students to use automated external defibrillators (AED) and to provide a basic data for helping laypersons easily apply the AED. Methods: The subjects were randomly assigned to instruction groups. One group was instructed by pictures (group P), one by videos (group M), and one by telephone dispatchers (group D), Without employing cardiopulmonary resuscitation, a single rescuer was asked to apply defibrillation to a mannequin for practice in accordance with the instructions assigned to each group. Results: Regarding the proper pad attachment of the AED, group P followed the instruction $0.31{\pm}0.47times$, group M, $0.81{\pm}0.40times$, and group D $0.69{\pm}0.47times$. Regarding the instruction of taking the hand off a patient for analyzing cardiac rhythm and the instruction of taking the hand off a patient before defibrillation, group P did not follow the instruction; group M followed the instructions $0.50{\pm}0.51times$; and group D followed all instructions at all times. Conclusion: If a dispatcher gives real-time instructions for using an AED to laypersons wtih no experience at the time of AED use, the quality of laypersons' AED use will greatly improve.
The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.
Purpose: This study was to review the previous studies on the 'Willingness to Pay (WTP)' for healthcare services and suggest future implications for nursing research. Methods: Using the scoping review method, we used RISS, KISS, KMbase, Koreamed, PubMed, EMbase, CINAHL as searching engines. According to the selection and exclusion criteria, 40 appropriate studies were selected and analyzed. Results: 24 studies were categorized into medical service field among medical, public health, and nursing service fields. A total of 16 studies were related to healthcare system (policies), 13 studies were to the healthcare intervention, and 11 studies were categorized into the health management. Most of the methods for eliciting WTP (70%) were about a contingent valuation method (CVM), and the use of double bounded dichotomous choice (DBDC) tended to increase. In the nursing field, five WTP studies were identified: two studies published in the early years of 2000, which were conducted on hospital-based home health visit services. Recent studies were mostly about counseling and education by advanced practice nurses (APNs). Conclusion: WTP studies on healthcare services were largely published from the medical fields and health policy areas with the CVM method. In the field of nursing, studies have been conducted on the subject of limited service areas. More active exploration of research topics is required, particularly under the current policy setting, where discussion of the public health insurance fee for nursing practice is essential.
As a part of improving early response system for senior emergency patients in rural areas in preparation for accelerated transition of Korea into aged society, this study seeks to make effective use of town broadcasting equipments and improve conventional educational ways for the first aid for senior people to boost up availability of private rescue personnel, so that it can contribute to improving capacity to early response to potential occurrence of emergency situations. In addition, this study focuses on profiling current activities of 119 geriatric Emergency Medical Services available in Korea, and also exploring possible ways to improve emergency services for senior safety which can play useful roles of social safeguard in imminent aged society as well as efficient ways to build up infrastructure for senior safety on the basis of opening up senior safety center.
Medical domain is very applicable for multi-agent system because medical information systems need much knowledge and close relationship with medical staff, In this paper, we describe design and implementation of an intelligent medical multi-agent platform that provides medical images'information services. This platform supports a physical environment that medical agents can be deployed following FIPA(Foundation for Intelligent Physical Agent)\`s agent management reference model. To use a variety of components on Windows, COM(Common Object Model) interfaces and XML(extensible Markup Language) for encoding ACL(Agent Communication Language) are used for multi-agent communications. Since many kinds of diverse and close relationships with medical staff) are essential, a medical staff is conceptualized as an agent and integrated with multi-agent systems. Also it provides an infrastructure applicable to share necessary knowledge between human agents and software agents in order to make intelligent medical information services easier.
The purpose of this study was to improve EMS-System in Korea through the research in EMS-System of advanced country. The response time is defined as the interval from the time of call receipt to the time of scene arrival. The important factor was to shorten moving distance of ambulance. It should be considered to accomplish this factor that the vehicle must be increased and the convenient location chosen for optimizing of service area. The transport of emergency patients carried out almost by 119 Emergency Medical Service but out of all the employees at 119 EMS only 11.3% have own qualified EMT degree. They should be employed more and more specially at 119 EMS for a superior level of emergency medical care for civilian. In America, EMT can take care of emergency patients following the order from medical Director at the scene of accident. But in Germany, prehospital care was emphasized from the beginning and, in those days, a medical doctor was sent for treatment of emergency patients at the scene, the so-called a Rendezvous system. Hierby this study makes the suggestion to improve the EMS-System, it is effective to use the medical Director system in America and furthermore a Rendezvous system in Germany. The functional integratin and unification of the report system as well as enough personal and equipmental elements saved together invaluable lives.
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.
Objectives : To determine the prevalence, pattern. and out-of-pocket expenditure of complementary and alternative medicine (CAM) utilization in Korean adult population. Methods : We conducted a representative telephone survey of 2,042 persons aged 18 or older. Data about any health problem, details of their use of medical doctors(MDs) offices/hospitals/pharmacies services and CAM during the preceding 12 months were collected with structured questionnaire. Results : The utilization rate of CAM among Korean adults was 29% in one year. A total of 231 kinds of CAM was identified from this survey. Annual out-of-pocket expenditure associated with CAM use in 1998 amounted to ${\xi}{\S}1.88$ billion and was comparable to 40.8% of out-of-pocket expenditure paid for MDs offices/hospitals/pharmacies services. Among those(N=424) who paid for both MDs offices/hospitals/pharmacies services an d CAM, 35.8% paid more for CAM. CAM gave more satisfaction than western medicine to those who had experience of both types of therapy. About half of CAM users were willing to recommend CAM to others. Disclosure rate to physician among CAM users was not high(40.6%). Conclusion : CAM became a popular source of health care in Korea, Korean spent a substantial amount of out-of-pocket money on CAM without any public control. Because CAM use is likely to be increased rapidly through lay referral system, health policy makers and health professionals should pay more attention to CAM for making appropriate utilization of CAM.
Fire service personnel and ambulance paramedics suffer musculoskeletal disorders as they lift and carry patients while performing Emergency Medical Services (EMS). The objective of the current study was performed to examine the association between working environment and musculoskeletal disorders of 119 paramedics and to analysis the EMS activities for them through basic survey (including task characteristics, risk factors, symptoms and illnesses). Observational job analysis of EMS activities indicated the squatting posture during first-aid performed on floor and the abrupt use of force during carrying heavy load including stretcher with patients on as hazard factors, and excessive low back twisting and bending during stairway transfer was observed. In addition, work-physiological assessment revealed various but rather high lumbar muscle usage rate among the study subjects, being 14.6~32.8% compared with Maximum Voluntary Contraction (MVC) during patients transfer work. Resting heart rate showed 65/min, on the other hand, heart rate on mobilization indicated maximum 124~156/min. Therefore, the results of analysis to the EMS activities, rescuer activities and medical tasks were accompanied with high possibility of accident and musculoskeletal disorders. Also, EMS activities indicated high muscle fatigue and energy consumption, and accumulated muscle fatigue with during continued work.
Objectives: It attempted to analyze influencing factors on the utilization of outpatient services which were adopted to predisposing, enabling, and need factors in Anderson model. Methods: The current study analyzed "2007 Korean National Health Nutrition Survey" data, which selected 3,335 people nationwide by proportional systematic sampling. This study analyzed data of persons who used outpatient services in two weeks. It adopted Anderson Model to control contextual factors including socioeconomic factors. The study compared means and fitted logistic regression models and multilevel model. Results: The logistic regression model showed that persons purchased private medical insurance were less likely to use outpatient services than the persons did not purchase private medical insurance. Persons with hypertension and diabetes mellitus, overweight, and problem drinkers were more likely to use outpatient services. Persons with high school graduates or higher in education level and experience of accidents or intoxications were more likely to use outpatient services according to the multilevel analysis of mixed model which treated region as random effect. Conclusion: Higher level of perceived stress increased the probability to use outpatient service than lower level of perceived stress. As number of days a person had exercised increased, the probability to use outpatient service decreased. Overweight and problem alcohol drinking increased the probability of outpatient service use. Further research should be conducted to find more factors influencing outpatient service use.
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