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Emergency Health Care Utilization according to Income class (소득계층에 따른 응급의료이용)

  • Choi, Ryoung;Hwang, Byung-Deog
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.78-96
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    • 2013
  • The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

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A Survey on Patient's Experience on Health Care Utilization and Perception of Health Care System for Developing of a Korean Medicine Clinical Practice Guideline for Traffic Injuries (교통사고상해증후군 한의표준임상진료지침 개발을 위한 환자의 의료이용 경험과 의료체계 인식도 설문조사 연구)

  • Park, Sun-Young;Lee, Sang-Hyun;Heo, In;Hwang, Man-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Park, Kyoung Sun;Ha, In Hyuk;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.139-152
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    • 2020
  • Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

Hazard Factors Assessment for the Fishermen's Safety on the Vessel of Offshore Stow Nets on Anchor using Insurance Proceeds Payment of NFFC (수협 재해 보험급여를 이용한 근해안강망 어선원의 안전 위험 요소 평가)

  • LEE, Yoo-Won;CHO, Young-Bok;KIM, Sung-Ki;KIM, Seok-Jae;PARK, Tae-Geun;RYU, Kyong-Jin;KIM, Wook-Sung
    • Journal of Fisheries and Marine Sciences Education
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    • v.27 no.4
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    • pp.1129-1135
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    • 2015
  • The stow net is a stationary gear made from netting, usually in shape like trawl net without wings. The nets are fixed by means of anchors, placed according to the direction and strength of the current. And the commercial fishing is associated with high rate of fatal and non-fatal occupational injury. The hazard factors analysis for the fishermen's safety of offshore stow nets vessel was conducted to serve as a basic data for improving the healthy and safe working environment of fishermen using fishermen's occupational accidents of the national federation of fisheries cooperatives (NFFC) from 2012 to 2014 (n=1,144). As a result, the average occupational accident occurrence rate of this fishery was 206.9‰ in all industries 36.9 times the rate of that. In addition, average death and missing rate was found to have a very serious level management to 50.4‰ in all industries of death of 42.0 times. The accident occurred in 84.5 to 94.6% was happened at sea. The struck by object, slipping, contact with machinery, contact by object or gear and others occurred more frequently in order on the frequency of accident occurrence pattern. However, the occurrence rate of death and missing did not match the frequency of accident pattern. In other words, slipping occurred frequently higher while death and missing risk was not high. And the contact with fishing gear and fall in the waters was low while death and missing risk was high. The results are expected to contribute for identification and assessment of safety hazard occurred in offshore stow nets vessel.

The Monitoring and persistence on the Total Amount of Vehicles in U-do Island (제주특별자치도 우도 입도 차량총량제 정책 모니터링과 지속성 연구)

  • Ko, Kee-Bong;Hwang, Kyung-Soo;Kim, Kyung-Bum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.471-480
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    • 2016
  • The purpose of this study is to identify the intent of the Total Amount of Vehicles policy that is enforced during the two summer season months (July and August) in U-do and the consequent problems after its implementation. We propose a basic direction for the policy to be sustainable. The average daily number of vehicles visiting was 645 in July 2015 and 953 in August 2015. As these numbers exceed the limit of 605, serious transportation problems such as traffic congestion and traffic accidents have occurred in U-do. We propose that the future direction of the policy is set forth as follows. First, mandatory reporting and the use of insurance, such as motorcycles, will have to be introduced along with measures to regulate violations. Second, a scheme needs to be introduced to enhance the total Amount of Vehicle policy and the number of inbound vehicles. Finally, public transportation cooperatives that are directly managed by local residents need to be established and an Eco-friendly vehicles dissemination policy introduced.

Whiplash Injury Conditions of Rear-End Collisions at Low-Speed (저속 추돌사고에서 목 상해 조건에 대한 연구)

  • Kim, Myeongju;Yun, Ilsoo
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.18 no.2
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    • pp.58-76
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    • 2019
  • As the number of reported injuries has tended to increase over time, large hospitalization expenditure from excessive medical treatments and hospitalization, and insurance frauds associated with moral hazard in minor collisions have caused a global societal problem. Many occupants of rear-ended vehicles involved in rear-end collisions complain of whiplash injury, which is also known as neck injury, without any anatomical and radiological evidence. With only clinical symptoms, stating that a whiplash injury is a type of injury defined by the Abbreviated Injury Scale would be difficult. Therefore, this study focuses on minor rear-end collisions, where the rear-ender vehicle collides with the rear-ended vehicle at rest. The mathematics dynamic model is employed to simulate a total of 100 rear-end collision scenarios based on various weights and collision speeds and identify how the weights and speeds of both vehicles influence the risk of whiplash injury in occupants involved in minor rear-end collisions. The possibility of an injury is very high when the same-weight vehicles are involved in accidents at collision speeds of 15 km/h or higher. The possibilities are 36% and 84% with collision speeds of 15 km/h and 20 km/h, respectively, if weights are disregarded.

Factors Influencing the Health Care Utilization of Disabled Workers Who Returned to Their Original Workplace after Occupational Accident (원직복귀 산업재해 근로자의 의료이용에 영향을 미치는 요인)

  • Hyun-Joo Lee
    • Journal of Industrial Convergence
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    • v.21 no.10
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    • pp.167-180
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    • 2023
  • The aim of this study is to explore the factors that influence the health care utilization of disabled workers who returned to their original workplace after an occupational accident. The study sample consisted of 457 workers who suffered from occupational accidents and were rated as disabled based on the data from the PSWCI in 2021. Data analysis was performed using a hierarchical multiple regression analysis with SPSS WIN 26.0. The study findings revealed that the number of outpatient visits was affected by factors such as daily wage payment, economic status, physical activity limitations, subjective health status, and chronic diseases. Moreover, health care expenditures were determined by factors such as having a caregiver for daily living, burn injuries, and physical activity limitations. Therefore, to increase the accessibility of health care utilization for disabled workers, the role of nurses in the workplace should be expanded, employers should include a health care utilization plan when developing a return-to-work plan, and research on the introduction of a paid sick leave system that allows workers to rest when they are sick is needed. It is also necessary to alleviate the economic burden by increasing the coverage of benefits for burn and rehabilitation treatments.

A Study on the Performance of Industrial Accident Prevention in Safety Management Institution -Focus on Comparison with Self-Managed Safety Workplace- (안전관리전문기관의 산업재해예방 성과에 관한 연구 -자체수행 안전관리사업장과 비교 중심-)

  • Seung-Kuk Lee;Seok-Jin Song;In-Sung Kim;Gyu-Sun Cho
    • Industry Promotion Research
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    • v.8 no.4
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    • pp.61-67
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    • 2023
  • This study compared, analyzed, and verified the accident rate and accident fatality rate (per 10,000 workers) of workplaces that perform safety management on behalf of a safety management institutions designated and registered in accordance with the OSHAct and workplaces that perform safety management. According to the research results, the significance was confirmed that the group with a low accident rate was the workplaces that self-appointed safety managers, workplaces with self-appointed safety managers in size with less than 300 employees, and workplaces in the industrial accident insurance industry in the manufacturing and transportation, warehouse, and telecommunications industries. The groups with a low accidental death rate were workplaces with less than 300 employees, workplaces where safety management was performed on behalf of safety management institutions, and workplaces with selfappointment for other medical businesses. In this study, it was confirmed that the accident rate in the safety management agency's workplaces was higher than that of its own appointed workplaces, and that there were some differences in the accident fatality rate depending on the size and industry. Therefore, since the current safety management agency system cannot ensure the effect of preventing accidental deaths, there is a need for comprehensive improvement of the agency system and improvement of the system to strengthen expertise in preventing industrial accidents.

Regulations of Launch Services and Management of Satellites in the Japanese Space Activities Act (인공위성의 발사 및 관리에 관한 규제 논점 - 2016년 일본 '우주활동법'을 중심으로 -)

  • Kim, Young-Ju
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.3
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    • pp.151-208
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    • 2020
  • Japan's two outer space-related laws were promulgated on November 16, 2016. There are the Act on Launching of Spacecraft, etc. and Control of Spacecraft (Act No. 76 of 2016, Space Activities Act) and the Act on Securing Proper Handling of Satellite Remote Sensing Records (Act No.77 of 2016, Remote Sensing Records Act). Japan's Space Activities Act states that a person who launches a satellite from the territory of Japan, or from a ship or airplane registered in Japan, must obtain permission from the Prime Minister prior to the launch. To obtain the permission, the person must have a certificate for a rocket design and for radio equipment at a launching facility. In addition, the ability to launch a rocket safely and the purpose for the satellite launch must be evaluated. Managing a satellite from Japan also requires permission from the government. A person who launches a rocket must have insurance for any potential damage arising from accidents, and the government is to supplement the potential compensation to allow for damage that cannot be covered by private insurance. The purpose of this paper reviews regulations of launch services and management of satellites in the Japan's Space Activities Act. It also offers some implications and suggestions for regulations of launching of spacecraft and management or operation of satellites.

Review of 2011 Major Medical Decisions (2011년 주요 의료 판결 분석)

  • Yoo, Hyun-Jung;Seo, Young-Hyun;Lee, Jung-Sun;Lee, Dong-Pil
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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Lung cancer, chronic obstructive pulmonary disease and air pollution (대기오염에 의한 폐암 및 만성폐색성호흡기질환 -개인 흡연력을 보정한 만성건강영향평가-)

  • Sung, Joo-Hon;Cho, Soo-Hun;Kang, Dae-Hee;Yoo, Keun-Young
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.585-598
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    • 1997
  • Background : Although there are growing concerns about the adverse health effect of air pollution, not much evidence on health effect of current air pollution level had been accumulated yet in Korea. This study was designed to evaluate the chronic health effect of ai. pollution using Korean Medical Insurance Corporation (KMIC) data and air quality data. Medical insurance data in Korea have some drawback in accuracy, but they do have some strength especially in their national coverage, in having unified ID system and individual information which enables various data linkage and chronic health effect study. Method : This study utilized the data of Korean Environmental Surveillance System Study (Surveillance Study), which consist of asthma, acute bronchitis, chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (congestive heart failure and ischemic heart disease), all cancers, accidents and congenital anomaly, i. e., mainly potential environmental diseases. We reconstructed a nested case-control study wit5h Surveillance Study data and air pollution data in Korea. Among 1,037,210 insured who completed? questionnaire and physical examination in 1992, disease free (for chronic respiratory disease and cancer) persons, between the age of 35-64 with smoking status information were selected to reconstruct cohort of 564,991 persons. The cohort was followed-up to 1995 (1992-5) and the subjects who had the diseases in Surveillance Study were selected. Finally, the patients, with address information and available air pollution data, left to be 'final subjects' Cases were defined to all lung cancer cases (424) and COPD admission cases (89), while control groups are determined to all other patients than two case groups among 'final subjects'. That is, cases are putative chronic environmental diseases, while controls are mainly acute environmental diseases. for exposure, Air quality data in 73 monitoring sites between 1991 - 1993 were analyzed to surrogate air pollution exposure level of located areas (58 areas). Five major air pollutants data, TSP, $O_3,\;SO_2$, CO, NOx was available and the area means were applied to the residents of the local area. 3-year arithmetic mean value, the counts of days violating both long-term and shot-term standards during the period were used as indices of exposure. Multiple logistic regression model was applied. All analyses were performed adjusting for current and past smoking history, age, gender. Results : Plain arithmetic means of pollutants level did not succeed in revealing any relation to the risk of lung cancer or COPD, while the cumulative counts of non-at-tainment days did. All pollutants indices failed to show significant positive findings with COPD excess. Lung cancer risks were significantly and consistently associated with the increase of $O_3$ and CO exceedance counts (to corrected error level -0.017) and less strongly and consistently with $SO_2$ and TSP. $SO_2$ and TSP showed weaker and less consistent relationship. $O_3$ and CO were estimated to increase the risks of lung cancer by 2.04 and 1.46 respectively, the maximal probable risks, derived from comparing more polluted area (95%) with cleaner area (5%). Conclusions : Although not decisive due to potential misclassication of exposure, these results wert drawn by relatively conservative interpretation, and could be used as an evidence of chronic health effect especially for lung cancer. $O_3$ might be a candidate for promoter of lung cancer, while CO should be considered as surrogated measure of motor vehicle emissions. The control selection in this study could have been less appropriate for COPD, and further evaluation with another setting might be necessary.

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