Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about traffic accidental patients. Methods : In following research, we surveyed 120 patients of traffic accident who were hospitalized in Dong-Shin Oriental Medical Hospital from October, 1, 2007 to August, 20, 2008 according to medical chart. Results : 1. In distribution of gender and age, the rate of male was 35.8%, that of female was 64.2% and the majority of the patients were twenties and thirties. 2. In the traffic accident patterns, the most was car crash from behind(61.7%) and after traffic accident, 75 patients(62.5%) visited our hospital for oriental medical treatment in less than 5days. 3. 46 patients(38.3%) choose the oriental medical treatment for the primary care and after medical care, 36 patients(31.7%) visited our hospital due to dissatisfaction of current treatment and maintained pain. 4. Partial pain was the chief complaint and the most of painful parts was neck(76.7%), followed by low back(69.2%). 5. Though radiation test, the most was cervical spine sprain(76.7%), followed by straightening of lumbar spine(66.7%). 6. In the periods of admission, less than 7 days was the most(53.3%), followed by less than 14 days(35.9%). 7. The treatment was effective to 93 patient out of 106 who had been hospitalized for less than 14 days. Conclusions : This data suggested that the Oriental medical care could be more effective treatment about traffic accidental patients without surgical injury.
Objectives : The purpose of this study was investigated that correlation between Temperament and Character Inventory(TCI) and Beck Depression Inventory (EDI). State-Trait Anxiety Inventory(STAI) in traffic accident patients. Methods: We investigated 30 cases of traffic accident patients. The patients answered that questionnaire about temperament. character and depression. anxiety. TCI and BDI. STAI were used to get to know that answers. Results: Depression is positive correlated with novelty seeking and harm avoidance in temperament. In character. depression is negative correlated with self directedness, and positive correlated with self-transcendence. Anxiety is positive correlated with harm avoidance in temperament. and negative correlated with self directedness. Conclusions : The results of correlation between TCI and BD I. STAI in traffic accident patients were consistent with previous studies in general person.
Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.
Recently the request of the patients to participate in the medical courses has been expanding due to elevated sense of right on the people's health. merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurses has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accidents. The following is the conclusion based by the above examination. 1) The general characters of the subjects of this study is that they are mostly single in their twenties and graduate from nursing college. Their total clinical career is above 5 years$(44.8\%)$ and their current clinical parts' career is between 1-3 years$(40.1\%)$. So these facts suggest that most hospitals has taken the working rotation policy on nurses. 2) The level of nurses' knowledge on the nursing law is accurate partially but isn't it patially. So it is suggested that nurses need the accurate information and education about the nursing law. But the nurses' attitude is very approved of the establishment of a unilateral nursing law. 3) The relation between the demographic characters of the subjects and their attitudes on the nursing law shows that there is no significant differences except the relation between the attitude 6(the sufficient level of education on nursing law in formal education course) and age. total clinical career. 4) The perception of the nurses shows that the cause of the nursing accident has been due to the heavy work$(78.2\%)$. short of professional knowledge and skill$(60.2\%)$, discordance with Doctors. patients and patients' families. They report the accident to the head nurse first$(81.8\%)$ and within 30 minute$(75.1\%)$. The hour of nursing accident frequently happened is regardless of service hour with $49.4\%$ in response rate. the highest rate. and the nursing accident happens in the night more than the daytime. Even though most nurses think that they are themselves responsible for nursing accident. it is found that the chief cause of the nursing accident is due to the nurses' heavy work$(78.2\%)$. So the causes of nursing accidents is analysed. it may be suggested that the endeavor of hospital and nursing organizations to decrease nursing accidents is very important. 5) The coping patterns of patients with nursing accidents are mostly active attitude such as a violent words$(69\%)$. sue or accusation$(36.4\%)$, monetary compensation $(35.6\%)$ except a understanding cases$(38.7\%)$. But the coping patterns of hospitals with nursing accidents are mostly to investigate the accurate cause.
Objectives: The purpose of this study is to develop a linking model between industrial injury insurance organs and local organizations providing social welfare health services, for the activation of medical rehabilitation services for industrial injury patients. Method: Research design for this study was a multi-step research through literature review, field research, and group interviews with persons in charge, to compare local society-oriented medical rehabilitation programs. The term of researches Sep.1 ~ Nov. 30, 2004. Results: 1. Home nurses from Workers Accident Medical Corporation have been taken to be adequate to case managers, who link industrial accident insurance institutions to local society services for the activation of medical rehabilitation services for industrial injury patients. They have been chosen for case managers because they have richer understanding and experiences of objects of industrial accidents than any other specialists, and because they have proved to be able to provide direct home services as a specialist. We have established the center for case management affairs within the workers accident general hospital, organized the committee for case management with doctors in charge, doctors in rehabilitation, rehabilitation consultants, social welfare workers, physical therapists, and nurses, determined objects of case managements from those of long-term recuperation, and constructed a course of case management containing from case management plans to evaluation. 2. We have made files of community resources, and organized the council of industrial accident administration to have it in charge of the adjustment and linking of services in case management affairs. 3. Because there are inequality of community resources between areas, differences in experiences in and bases for linking, and disparity of core organizations with active linking in the system of linking between public and civil sectors, we have taken a system of linking between parallel organs to be the core. In our linking model, workers accident general hospital, hospitals designated for industrial injury, and rehabilitation hospitals are linked in parallel, inadequate long-term recuperation managers are trusted to an workers accident medical corporations through examination by the examination committee in Korea Labor Welfare Corporation, and are dealt with by the committee for case management. Of the hospitals designated for industrial accidents, those running a home caring center provide home caring services for the handicapped at home from industrial injury. 4. Workers Accident Medical Corporation take part in medical rehabilitation, and Korea Labor Welfare Corporation in vocational/social rehabilitation. Furthermore, in the model, the latter should construct a system for job opportunities through Internet portals and provide cyber vocational consultation and introduction. Conclusion: Improvement of systems is needed to apply the linking model to practical affairs. Because this model is centered for practical affairs, it should be put under the analysis of effects, and evaluation of its adequacy to practical application, and its effects and efficiency through experimental running in the 8 workers accident general hospital in Korea.
Objectives: This study intends to analyze the relationship between medical service experience and subjective health awareness by using data from Panel Study of Worker's Compensation Insurance(PSWCI). Methods: Tte χ2-test was performed to investigate subjective health awareness and medical service experience relevance. Logistic analysis was performed to analyze the influencinge factors. Results: The subjective health awareness scored "bad" in"'lack treatment period" compared to "adequate treatment period" in medical service experience (OR = 2.603 [95% CI = 1.666-2.555]). Conclusions: To improve the subjective health awareness of patients with industrial accidents, the industrial accident compensation and medical care approval system should be improved, and long-term industrial accident insurance policies should be developed to accommodate direct and indirect medical services.
Purpose: To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province. Methods: We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015. Results: The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia. Conclusions: As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.
The present study aimed to compare and analyze the particulars of and difference in medical expenses and their composition ratio for 2,026 patients hospitalized at 2 types of medical institutions (443 at a clinic and 1,583 at a hospital) in Jeonju-si, Jeollabuk-do under coverage of automobile insurance during 2009. From the analysis, it became evident that there were differences in individual characters of inpatients covered by automobile insurance, and details, composition and composition ratio of medical treatment for them depending on types of medical institutions. There was no difference, however, between the total and average medical expenses per capita even when markup rate was applied to the automobile insurance by types of hospitals. The ratio of radiotherapy and physical therapy in the composition of medical expenses was found to be extraordinarily high in clinics compared to that of hospitals. The composition ratio of the fixed cost including charge for hospitalization also turned out to be fairly high in all medical institutions.
This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.
A retrospective study has been carried out for 47 cases of traffic accident victims which was entered to the Dongguk Bundang O. M. Hosp. from Jan 1, 1999 to May 4, 2000. This study was focused on finding out the distribution, pattern of the traffic accidents, clinical characteristics of the patients, motives of their choosing oriental medical treatments, the kinds of oriental medical treatment. This results were as follows : 1. The highest incidence was shown in the age of twenties to thirties as much as 59.6% and the ratio of male to female was 17:30. 2. 80.9% of all patients was injured by car accidents. 68.2% of all patients was injured as drivers and passengers and 19.2% was injured as pedestrians. The highest type in the collision between cars, was rear impact. 3. The number of patient(61.7%) via other hosp. was more than that of the first visitor(38.3%) to our hosp. 4. In admission motives, The patients who had been treated by western medical treatment, expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. Also The others wanted to be treated by oriental medical methods in the reason of no deep surgical, orthopaedical lesions 5. C-spine sprain(80.9%) was the most frequent out of all patients's diagnosis and then L-spine sprain(51.1%), contusion(46.8%), etc. 6. Head Cervix(80.9%) was the commonest pain region of all patients. and then shoulder back(70.2%), lumbar region(61.7%), etc. 7. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 8. After discharge, Duration of OPD treatment was long as much as that of admission treatment. 9. At first stage of admission period, Herb medication was frequently prescribed for hwalhyultonglakgige(活血通絡之劑). but As going to end stage, was frequently used for bogi(補氣) bohyul(補血), gudam(祛痰), ansin(安神).
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