• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.253-261
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• 2001

Objectives : To evaluate the hypothesis that air pollution could increase emergency room visits for respiratory diseases, and if so, to quantify the strength of association between those. Methods : We compiled daily records of hospital emergency room visits for respiratory diseases in Seoul, from November 1. 1955 to October 31. 1996, by using medical utilization data of unscheduled visits. In addition, air quality and weather data for the same period was collected. And a case-crossover design was applied by adopting conditional logistic regression analysis to determine the relationship between air pollutants and emergency room visits for respiratory diseases. In particular, the control periods were chosen by a bidirectional paired matching technique 7, 14, and 21 days before and after the case periods. Results : Only ozone was associated with the increased number of emergency room visits for respiratory diseases. The relative risk according to a 30ppb increase of ozone concentration (24hr mean, lagged 1day) was 1.91(95% confidence interval = 1.78-2.05). Conclusion : There was a statistically significant association between the ambient ozone and daily emergency room visits for respiratory diseases.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.61-72
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• 2001

Objectives : To evaluate the hypothesis that increasing ambient levels of ozone or particulate matter are associated with increased emergency room visits for asthma and to quantify the strength of association, if any, between these. Methods : Daily counts of emergency room visits for asthma, air quality, and weather data were collected from hospitals with over 200 beds and from monitoring Stations in Seoul, Korea from 1994 through 1997. Daily counts of emergency mom visits for asthma attack were analyzed using a general additive Poisson model, with adjustment for the effects of secular trend, seasonal variation, Sunday and holiday, temperature, and humidly, according to levels of ozone and particulate matter. Results : The association between daily counts of emergency room visits for asthma attack and ozone levels was statistically significant in summer(from June to August), and the RR by unit inclement of 100 ppb ozone was 1.30(95% CI = $1.11\sim1.52$) without lag time. With restriction of the period from April to September in 1996, the RR was 1.37(95% CI = $1.06\sim1.76$), and from June to August in 1995, the RR was 1.62(95% CI = $1.12\sim2.35$). In the data for children$(5\sim14yr)$, the RR was 2.57(95% CI = $1.31\sim5.05$) with restriction of the period from April to September in 1997. There was no Significant association between TSP levels and asthma attacks, but a slight association was seen between PM10 levels and asthma attacks in a very restricted period. Conclusion : There was a statistically significant association between ambient levels of ozone and daily counts of emergency room visits for asthma attack. Therefore, we must make efforts to effectively minimize air pollution, in order to protect public health.

• 보건행정학회지
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• 제23권2호
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• pp.176-187
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• 2013

Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

• Journal of Preventive Medicine and Public Health
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• 제51권3호
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• pp.154-162
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• 2018

Objectives: Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction. Methods: A secondary analysis of data from the 2015 Korean Society of Emergency Physicians Survey was performed. The variables potentially influencing early retirement were organized into personal characteristics, extrinsic factors, and intrinsic factors. Logistic regression analysis was performed to identify risk factors and to develop a probability equation; these findings were then arranged in a nomogram. Results: Of the 377 survey respondents included in the analysis, 48.0% intended to retire early. Risk factors for early retirement included level of satisfaction with the specialty and its outlook, slanderous reviews, emergency room safety, health status, workload intensity, age, and hospital type. Intrinsic factors (i.e., slanderous reviews and satisfaction with the specialty and its outlook) had a stronger influence on early retirement than did extrinsic factors. Conclusions: To promote career longevity among EPs, it is vital to improve emergency room safety and workload intensity, to enhance medical professionalism through a stronger vision of emergency medicine, and to strengthen the patient-doctor relationship.

• 한국방재학회:학술대회논문집
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• 한국방재학회 2008년도 정기총회 및 학술발표대회
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• pp.393-394
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• 2008

Recently keeping pace with globalization, many international conferences and athletic games are being held in Korea. After 911 terror in New York in 2001, Korean government dispatched Zaytun Division in Iraq and this fact has also led to voice concerns that Korea should be prepared to protect from biological terrors as soon as possible. It is important to develop the bioterrorism emergency medical training for public health students including paramedic in Korea. So I propose the development of bioterrorism education curriculum.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2000년도 제52차 추계학술대회 연제집
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• pp.197-198
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• 2000

• 디지털콘텐츠학회 논문지
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• 제19권3호
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• pp.587-593
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• 2018

증후군감시는 감염병 발생 초기에 나타날 수 있는 임상적 증상 발생동향을 감시하여 감염병의 발생을 가능한 조기에 인지하기 위해 고안된 감시체계이다. 한국 질병관리본부에서는 응급실 기반의 증후군감시시스템을 개발하였으며, 현 시스템의 기능을 강화하고자 국외 증후군감시 조기경보시스템에 관한 문헌조사를 하였다. 본 논문에서는 국외 증후군감시 조기경보시스템 운영현황을 설명, 비교하여 한국의 응급실 기반 증후군감시를 위한 조기경보시스템의 개선에 필요한 근거자료를 마련하였다.

• 한국보건간호학회지
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• 제9권1호
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• 보건행정학회지
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• 제33권3호
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• pp.264-272
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• 2023

Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.47-54
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• 2001

Objectives : To analyze factors associated with elderly falls in a community dwelling, a comparatively important, but somewhat neglected, health mailer. Methods : Data came from personal interview surveys using a questionnaire of 552 people aged 65 or older living in a community. Socioeconomic, and health related characteristics were investigated as independent variables and experiences of falling in the previous year as the dependent variable. Results : 118(21.4%) of the elderly subjects experienced a fall in the previous year. 24 subjects experienced more than two falls, accounting for 20.3% of the elderly fall victims studied. Factors affecting the falls were families living together, level of daily activity, heart disease, and aconuresis;, therefore an elderly person who lives alone, lives independently, has heart disease, or suffers urinary incontinence had a demonstrated increased chance of failing. Conclusion : Groups at risk for luting included elderly persons living alone, living independently, suffering heart disease, or experiencing urinary incontinence. When an elderly fall prevention program is developed and implemented, these results should be considered.