• Quality Improvement in Health Care
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• v.5 no.1
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• pp.2-14
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• 1998

The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.

• 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.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.125-134
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• 2010

This study has been conducted to estimate the degree of cognition of military hospital services according to experience of military hospital services for serviceman, and to find out some factors affecting the medical services satisfaction. Questionnaires were given to 600 persons during October 5th though 24th 2009. All 600 questionnaires distributed affair, but 343 cases were collected. Statistical analysis methods used in this dissertation are t-test, Logistic Regression Analysis and other basic statistics such as frequency, percentage, and standard deviation using SPSS ver, 17.0. Results of the study are as follows: The satisfaction of the treat a patients' to compared military hospital and private hospital was providing free medical treatment for serviceman. The dissatisfaction of the treat a patients' to compared military hospital and private hospital was army doctors treated his very unfriendly. The level of medical treatment to providing military hospital was very low cognition for serviceman. In conclusion, to increase the preference of the military hospital is level of private hospital health care level of should be to developed. More support to financial should provide for medical workforce and setting of cutting edge medical equipment in the military hospital. Military hospital is should be competition with private hospital. Also should be improve the quality of military medical service.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.119-127
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• 2022

Purpose: This study aimed to examine the necessity of administrative compensation insurance and claims cases during the emergency medical service process among administrative compensation insurance cases and suggests problems and improvement measures. Methods: We compared the details of administrative compensation insurance claims of 15 cities and provinces, excluding Seoul and Kwangju, from 2017 to 2020 by requesting details disclosure of the comprehensive deduction for administrative compensation in 17 cities and provinces across the country. Results: A total of 69 cases were compensated through the administrative comprehensive compensation deductions. There were 53 cases of damage that occurred at the field stage, 14 cases at the transfer and hospital stage, and two other cases. Conclusion: The 119 paramedics, which are the perpetrators, should be active in field activities and free from the psychological pressure caused by increased workload and litigation. Active compensation administration is required for damage cases occurring in the firefighting activities context.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.147-178
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• 2003

In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations : Building up security system along with operational expansion, building up a system for emergency medical treatment, buliding up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119, we can review the following considerations : Improving the education for fire fighting trainging corps under Jeju Provicial Fire and disaster management department, providing rescue members with more opportunity for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. Provide little more superior quality high fire fighting service to jeju islander, and need long-term and elaborate research to correspond in rising fire fighting man-power demand newly and investment. Construction of well-matched disaster administration system is assignment that must hurry in international free city. That jejudo receives time factor about that is received for another thing area's number of persons or equipment when regional special quality large scale or disaster happens is that of course the support receives limitation immediately. Jeju fire fighting services is one story reform, specialization taking into account particular situation of jeju area to grow as sightseeing and center of culture intending international free city, should be upgraded. So, it may do big contribution naturally in jeju international free city phase that coincide jeju islander's social welfare promotion and safety desire.

• Archives of Plastic Surgery
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• v.50 no.3
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• pp.264-273
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• 2023

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

• International Journal of Contents
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• v.13 no.2
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• pp.14-20
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• 2017

The purpose of this study was to investigate the association of obesity with medical care use and costs according to overall diseases, cerebrovascular diseases (CVD), ischemic heart disease (IHD), hypertension (HTN) and diabetes mellitus (DM). The final sample was a group of persons who were free of diseases mentioned above and were not underweight. Their baseline screening program data and health insurance contribution data were connected with a 7-year medical claim database. The participants were classified according to their baseline BMI into normal, overweight, obese, and severely obese groups. Given the disease type, the total costs of DM showed the largest difference in each obesity group in both males and females. Also, the pharmacy costs for DM were more relevant than any other type of service to the obesity level. Considering the high prevalence of obesity and the relevantly increased medical care use and costs, there is a need for reduction in medical costs through obesity prevention efforts.

• Perspectives in Nursing Science
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• v.12 no.1
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• pp.1-6
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• 2015

Purpose: The purpose of this study is aimed to examine the Free Trade Agreement and its General Agreement on Trade in Services, especially, the healthcare service and the prospect of the system. Methods: This study was based on fourteen literature reviews from 2001 to 2014. Results: Free Trade Agreement and the General Agreement on Trade in Services were examined and Japan, China, and the United States's examples were shown. Healthcare market opening issues are the tendency of this era with the concept of globalization. Conclusion: This study highlights the tendency of healthcare market opening with all the pros and cons. The healthcare system along with the medical and nursing fields need to modify their system based on the globalization.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.1-14
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• 2018

Objectives : The purpose of this study was to analyze the effect of welfare system of medical institutions on job satisfaction and organizational commitment of female workers. Methods : A survey was performed with 556 female workers of 11 general hospital and 7 acute period hospital in Busan. Data were collected from October to November 2017 with a self-report questionnaire and analyzed using SPSS 24.0. Results : Among those aged over 40 years, high awareness of obligatory welfare, job education, free use of the annual leave, and flexible working system was a positive factor in job satisfaction. Among managers, free use of the annual leave, job education, flexible working system and child-care facilities was a positive factor in organizational commitment. Conclusions : In medical institutions with a relatively high proportion of married women, although interest in welfare for childbirth and child rearing is high, execution is sluggish, hence, policy support of government and medical institutions in this field is necessary.

• Korean Medical Education Review
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• v.21 no.2
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• pp.92-99
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• 2019

The aim of this study was to use narrative inquiry to explore the experiences of medical students who faced expulsion, military service, and readmission, and their journeys of identity formation. Three medical students were recruited via snowball sampling, and each participant was interviewed twice. According to the sequence of experiences, their stories were summarized as follows: the process of being expelled, the military service experience and readmission process, and the present. Before all three students were expelled, they lived dissolute lives free of concern from the entrance examination and failed to cope well with dropping out. They felt that military experience had helped them develop interpersonal skills in the clinical setting and the strength to withstand a difficult crisis. Two students were motivated to become doctors after military service, but the other was not. They had reflected deeply over their unique experiences. The scars imprinted from their experiences became a means of stimulation, and they ultimately acquired the resilience and ability to accommodate for and counteract their weaknesses. This appears to have been an important influence on their identity formation. The narrations of their rare experiences can help medical educators more fully understand and support medical students through difficulties, specifically with regard to academic failure or expulsion. These findings may prompt medical professors to think about the kind of guidance or motivation that could help students before expulsion, rather than assuming that they are simply lacking academic ability.