Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.
The aim was to describe out-of-hospital cardiac arrest (OHCA) occurring in the workplace of a large emergency network, and compare the evolution of their management in the last 15 years. A retrospective study based on data from the Northern Alps Emergency Network compared characteristics of OHCA between cases in and out the workplace, and between cases occurring from January 2004 to December 2010 and from January 2011 to December 2017. Among the 15,320 OHCA cases included, 320 occurred in the workplace (2.1%). They were more often in younger men, and happened more frequently in an area with access to public defibrillation, had more often a shockable rhythm, had a cardiopulmonary resuscitation started by a bystander more frequently, and had a better outcome. Cardiopulmonary resuscitation started by a bystander was the only chain of survival link that improved for cases occurring after December 2010. Workplace OHCA seems to be managed more effectively than others; however, only a slight survival improvement was observed, suggesting that progress is still needed.
Purpose: The purpose of this study was to determine the effect of an education program promoting attitude, knowledge, and practice of safety for teachers in child care centers. Method: This education was provided at one public health center in Kyunggi Province. One group pretest-post test design was used, and knowledge on safety and emergency care, practice of safety, health belief and self confidence on safety practice were assessed from 74 teachers. Theoretical framework for this program was Pender's health promotion model. Result: After two hours group education session on safety management, knowledge on safety and emergency care was significantly increased and perception on the main cause of injuries was significantly changed. Practice on safety was significantly related to the knowledge, health belief and confidence on safety, and social support. Conclusion: The education program for teachers in child care centers regarding the child safety and emergency care was effective in promoting knowledge and perception on the main cause of injuries of infants.
Sohn, Sangho;Cho, Wonju;Kim, Jin A;Altaluoni, Alaa;Hong, Kwan;Chun, Byung Chul
Journal of Preventive Medicine and Public Health
/
v.52
no.2
/
pp.82-91
/
2019
Objectives: Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. Methods: Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. Results: A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a $1^{\circ}C$ increase in pneumonia temperature above the threshold of $6^{\circ}C$ was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. Conclusions: The term 'pneumonia temperature' is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.
The results of analyzing the cognition of CPR by college students who major in public health or not order to enhance the educational efficiency of first aid ability and its expansion are as follows. 1. In case of students majoring in public health, the students who have the knowledge of term 'CPR' are 95.3% of total 300 students and 62.6% of the students who don't major in public health know it. In the item test of examining the degree of theoretical knowledge of CPR, the cases who know all 12 items are 5.2% and 1.6% respectively in cases who major in public health and don't major in it and it is judged that the extension of educational opportunity for them should be urgent. 2. The students who have experienced the practice of CPR are 20.6% in case who major in public health and 7.4% in other case. Therefore it seems to desirable that indirect field experience should be obtained by strengthening practice centered education. 3. The order of practice to examine the CPR ability is asked and the students who show very good remark are just 21~22% in both cases and they conducted very ineffective CPR and it is examined that they did first aid which may a serious damage to patients. Then the cases who recovered pulse and respiration after CPR were very low as 28.8% in the students who major in public health and 35.7% in others. It is therefore considered that the exact education of conducting the maintenance of respiratory trace, artificial respiration and CPR is necessary. 4. The cases who had the education of CPR were 51% in the students who major in public health and 39.4% in others, who had little opportunities to have CPR and 92.5~93.2% in both groups fee the necessity of continuous education and it is very encouraging to extend the education of CPR. 5. The education of CPR is mainly done at school (70.3~79.4%) and from teachers (52.7~55.4%) and 71.2% of the students majoring in public health responded that it is good for them to have education of CPR at school and lecture by first-aider and 58.9% of others did it. The cases who ask for lecture by the Professors of Dept. of First-Aid are 11.8 in students majoring in public health and 13.1% in others and it is judged that lecture by them having the theoretical foundation and first-aider with practical ability will be desirable. 6. On teaching methods, 57.5% of the cases majoring in public health and 63.3% of others ask for practice and 20% of both groups need theory centered teaching. 7. On lecture fee, 83% of the cases majoring in public health and 83.3% of others consider it should be free and 8~11.8% who are to pay for 10,000 won and it is judged that it should be opened and operated as liberal arts by college in the dimension of lifelong education. 8. On the objects of education, 83% of cases majoring in public health and 66.6% of others consider it should be conducted in people of all ages and both sexes and it is known that everyone recognizes the necessity of popularizing the education of first-aid.
We consider the economic value of emergency medical facilities. An emergency medical facility affects the medical environments in a community, and thus the social demand on the facility increases as the demand of qualified public health service increases. Regarding the increased demand and the limited resources of fiscal budget, it is important to scientifically evaluate the social benefit of the public investment on emergency medical facilities, as the results of evaluation can help make better budgetary decision on each public investment project of emergency medical facilities. In this paper, we try to estimate the economic value of emergency medical facilities based upon the estimated changes in preventable death rate by the facility and the statistical value of life. We hope the results contribute to improve the budgetary decision making on the emergency medical facility projects, thus the public health policies.
Purpose: This study aimed to identify the factors affecting the emergency response ability to develop an education program to strengthen the emergency response ability of caregivers having the highest probability of discovering emergency situations. Methods: This study is a descriptive research study conducted by 204 caregivers working in elderly care facilities and home care centers located in one area. The collected data were analyzed by independent t-test, one-way analysis of variance (ANOVA), Pearson's correlation, and multiple linear regression using the Statistical Package for the Social Sciences (SPSS) 25.0 statistical program. Results: First aid knowledge was related to work time (F=3.52, p=.008), number of care people (F=2.58, p=.038), workplace (F=6.76, p=.001), and self-efficacy (F=3.70, p=.026), and the ability to cope with emergency situations showed a statistically significant difference in education level (F=3.58, p=.015). There was a positive correlation between self-efficacy and emergency response ability (r=.179, p<.05), and the factors affecting emergency response ability were education level (β=-.164, p=.050), workplace (β=.290, p=.023), and self-efficacy (β=.103, p=.022). Conclusion : Factors influencing the improvement of caregivers' ability to cope with emergency situations, workplace, education level, and self-efficacy were found. Thus, it is suggested to develop and apply an emergency education program to increase self-efficacy and consider the workplace and educational level.
Kim, Chae-Bong;Han, Min-Kyung;Jeong, Mi-Seon;Choi, Bo-Young;Choi, Kil-Yong;Kim, Moo-Young
The Korean Journal of Health Service Management
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v.9
no.3
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pp.175-185
/
2015
Objectives : This study was did a meta-analysis of emergency room visits decreased effectiveness of self management education interventions in asthma among adult patients with asthma. Methods : A search of the database PubMed resulted in identifying 8,619 studies done between January 1990 and November 2012. STATA version 10.0 was used to analyze the effect size, explore possible causes of heterogeneity, and determine publication bias with a funnel plot. Results : We included 7 cases on emergency room visits decreased effectiveness of self management and education. Asthmatic patients experienced fewer attacks (summary effect size, 0.75; 95% confidence interval [CI], 0.65-0.95). We found that emergency room visits decreased effectiveness of self management and education were associated with statistically significant effects. Conclusions : Based on these finding, self management and education on interventions are necessary to prevent asthmatic attacks in patients and to reduce the severity of the attacks, and self management and education programs are needed in Korea.
Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.
One of the main indicators of the health status of a country is the Maternal Mortality Rate (MMR). In order to improve the MMR in Indonesia, the government has made a number of primary health centers (PHC) capable of providing basic obstetric and neonatal emergency care (PONED) services. The aim of this research is to learn how well PONED services have been implemented at the Baso PHC in Agam Regency as of 2015. We used a qualitative approach, with in-depth interviews and observations from June-August 2015. Ten respondents participated in the in-depth interviews, and observations were made about the infrastructure. The validity of the data is based on the standard of credibility, transferability, dependability, and confirmability of the content of the interviews. The analysis shows that there are still some obstacles in PONED PHC implementation, including the lack of human resources at the PHC and insufficient facilities, funding, and oversight, which causes many cases that should be handled by a PONED team to be referred to the hospital. Suggestions are provided to help improve policies and ultimately patient care.
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