Purpose: Korean medical services are not balanced across regions and social classes. To prevent mortality gaps, Korea must distribute its medical resources more efficiently. Patient factors affecting emergency room visits serve as basic data for determining best practices for public healthcare distribution. Methods: The data included 18 473 visits by 14 949 de-identified patients who visited a public emergency room over one year. The dependent variable was the number of emergency room visits. A Poisson regression was conducted with the independent variables, comprising sociodemographic, socioeconomic, and spatial accessibility factors and patient characteristics. Results: Older men with higher Korean Triage and Acuity Scale scores visited more frequently. Greater patient-hospital distance decreased visits; however, the presence of a hospital within 1 km of a patient's residence did not affect the number of visits. The use of 119 services was negatively correlated with the number of visits. Visits increased with more medical benefits. Conclusions: Patient age, distance to hospital, use of 119 services, and medical benefits should be considered when planning or managing public hospitals in Korea.
Purpose : We try to disclose how much the keywords of the papers from the Korean Journal of Emergency Medical Services with Medical Subject Headings(MeSH) terminologies and to understand the major subjects of the recent emergency medical technology research in Korea from keywords. Methods : We analyzed keywords from 524 articles of the Korean Journal of Emergency Medical Services that were published between 2005 and 2011. We investigated frequently used keywords and what percentages of keywords agree with MeSH terms using the MeSH browser. Results : There were on average 3.2 keywords per article. The most frequent key words were AED, Attitude, Cardiopulmonary Resuscitation, CPR, EMT, EMT students, External Defibrillator, Job satisfaction, Knowledge, 119 EMT in order. The number of terms in precise agreement with MeSH headings was 101(19.3%); 327 terms(62.4%) were not found in the MeSH browser and 96 terms(18.3%) partially matched MeSH terms. Conclusion : Many keywords used in the Korean Journal of Emergency Medical Services did not agree with MeSH terms. We conclude that contribution rules should be using MeSH terms and authors should be educated in the proper use of MeSH terms in their research and subsequent publication.
Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.
The purpose of this study is to propose ways of promoting medical tourism in Busan. For the purpose, this researcher made a questionnaire survey of Japanese tourists who used in Busan International Ferry Terminal between January and April 30, 2008. Findings of the study can be summarized as follows. 86.3% of all respondents had never experienced any medical service in Korea. 57.3% said that the most important thing is the level of medical technology. Most of respondents preferred massage treatment using spa and sea water, followed by Oriental medical services. To make medical conditions(price competitiveness, high-level medical technology, high-quality medical facilities) of Busan properly informed to the outside, it is required to make the city itself more internationally recognized through public relations and strengthening individual medical services provided in the city. It is also required to build up a non-stop service system that helps foreign tourists not only easily use medical institutions, but also better cope with a variety of problems that they might face during stay in the city. To be more trustable to foreign patients, medical services of Busan should be certified by JCI. Furthermore, it is very much needed to develop products which connect medicine with tourism, for example, such programs that combine medical services, tourism, recreation and leisure.
This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.
Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion: For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.
Park, Jeong Ho;Moon, Sung Woo;Kim, Tae Yun;Ro, Young Sun;Cha, Won Chul;Kim, Yu Jin;Shin, Sang Do
Clinical and Experimental Emergency Medicine
/
v.5
no.4
/
pp.264-271
/
2018
Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.
International Journal of Internet, Broadcasting and Communication
/
v.10
no.3
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pp.98-103
/
2018
Globally, medical tourism draws attention as a national growth engine industry, and is actively expanding. Current medical tourism leans towards large hospitals making it difficult to attract new users. Users collect the information for medical tourism through various paths in order to receive medical consultations and customized tour services. To expand medical tourism to small and medium sized hospitals, it is necessary to have customized medical consultations, tours and interpreter services, which are the key elements of medical tourism. This paper suggests services that users can use to match medical consultations and find tours and interpreters they want at the same time. This paper suggests ways to provide integrated services based on the information experienced by users, combining the required items from the perspectives of each user, hospital and guide. To match the content provided by hospitals and guides with experience information from users systematically, this study suggests the convergence plan for a service model that can match the experience information between users and hospitals, between users and guides and between hospitals and guides systematically by operating the data in the universal container.
Purpose : This study was conducted to understand Oriental medical health services and analyze the relationships between the perceived Oriental medical health services and the effect, influencing patient satisfaction as. well as intentions of re-visiting such hospitals. Methods : SPSS 10.0, a statistical processing method, was used to process the study data and frequency and ANOVA analysis were used to analyze the differences. Also, Pearson correlation coefficient was performed to analyze the relationships between work satisfaction and health services quality, as well as patient satisfaction and intentions to re-visit such hospitals. Results : Most patients were satisfied with the service, but it was shown that improvement of facilities and medical equipment was needed. The survey showed higher satisfaction with longer experience of doctors and nurses. Staff recognition of health services quality seemed lower than patient satisfaction, so efforts to improve the health services and relationships between health services quality and patient satisfaction are necessary. Conclusion : Higher quality and satisfaction with Oriental medical health services are going to improve total re-use intention to a significant degree.
Journal of the Korean Society for information Management
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v.39
no.1
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pp.281-308
/
2022
This study aims to present directions for improving information services of medical libraries in small and medium-sized hospitals by exploring the information use behavior and information needs of nurses, medical technicians, and pharmacists who had not been studied. The research design was conducted based on the reviewing theoretical background studies, and in-depth semi-structured interviews were conducted with nurses, medical technicians, and pharmacists working in small and medium-sized hospitals. The results show their information needs, information use behavior, and perceptions of the medical library in the hospital. Based on these results, this study suggests ways to improve the information services provided by medical libraries in hospitals. This research is meaningful because it was first to explore the information use behavior and information needs of health care professionals working in small and medium-sized hospitals.
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