The health and medical service attracts more public attention as the economy of Korea is rapidly growing up and the standard of living is elevated. Especially, the interest and demand on the prehospital emergency medical service that consists of the important part of primary medical service that is directly related to the life of patients are gradually increased. However, as compared with other advanced countries such as America in this area, Korea actually fell behind in the utilization of IT (Information Technology) to maximize the efficiency of emergency service system as well as has a problem in the general service system. This study suggested the necessity to introduce EMD (Emergency Medical Dispatch) system that takes a great role as the core part in the prehospital emergency medical service that is not systemized in Korea yet. In addition, this study proposed the implementation model of EMD ASP system using ASP (Application Service Provider) in EMD system to flexibly deal with the change of IT and efficient implementation and integration of information system as well as to significantly reduce cost through wire/wireless high speed Internet network that is politically promoted in Korea on the basis of EMD. The system analysis and design was executed by HIPO (Hierarchy Plus Input Process Output) analysis that was the conceptual design technology for EMD information system modeling based on ASP and DFD (Data Flow Diagram). This study proposed DB table configuration and data schema to implement the application of web browser interface in EMD system through ERD(ER-Diagram) of EMD ASP system. Finally, this study described how to implement and utilize EMD information system. This study aims to facilitate the qualitative development of emergency medical service in the future as suggesting the concrete models for the implementation of high value-added prehospital emergency medical information system as applying ASP concept to EMD system of prehospital emergency medical service area.
Mohd Fazeli Sazali;Syed Sharizman Syed Abdul Rahim;Ahmad Hazim Mohammad;Fairrul Kadir;Alvin Oliver Payus;Richard Avoi;Mohammad Saffree Jeffree;Azizan Omar;Mohd Yusof Ibrahim;Azman Atil;Nooralisa Mohd Tuah;Rahmat Dapari;Meryl Grace Lansing;Ahmad Asyraf Abdul Rahim;Zahir Izuan Azhar
Tuberculosis and Respiratory Diseases
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제86권2호
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pp.82-93
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2023
Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.
Purpose: This study was conducted to identify the status of health management and to evaluate the need for health professionals in day care centers in the South Korea. Method: Data were obtained from 360 child care providers in 16 provinces from May to August, 2007. Data was analyzed using SPSS WIN 14.0. Results: Safety education (traffic. 83.8% general safety. 71.6%) was provided more often than the other topic of education. All health related education was provided by child care providers. When minor health problems occurred, the most common management strategy was to send the child home (36.1%). During emergency conditions, majority of child care providers preferred taking the children to medical centers without giving any emergency care and 19.4% reported sending the child home without any immediate care. Child care providers recognized the need for health care professionals. Conclusion: The results of this study suggest the need for services of health professionals in day care centers to satisfy the needs and expectations for health management in these centers. As health professionals, public health nurses or pediatric nurse practitioners may play an important role in health management of children in day care centers.
Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.
Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.
Objectives: The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries. Methods: To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022). Results: The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification. Conclusions: The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic's adverse health impacts, more so than emergency containment measures and social restrictions.
In Korea, EMS Fund Operation seems to move the opposite direction to right way. The most initial EMS fund was consumed loan for some emergency patients without any particular results. Since 2002, the use of EMS fund also has shown a tendency to shift one side. By the results, it was 44.3% to support emergency medical centers, so called hospital EMS system and 28.4% to purchase ambulances and helicopters, and 1.6% to operate Central Medical Center, prehospital base in the EMS fund consumed in 2004. It was never supported for the environmental improvement and development of universities, colleges, and private EMS units having the primary responsibilities. The initial EMS fund using should be used for prehospital base, e.g., prehospital staffs, communications, and facilities and balanced development between public and private EMS units than any other fund using.
Purpose - This article tackles risk communication issues and aims to address the characteristics of MERS risk information distribution in South Korea, and secondly to examine the communicative behavior of the public health authority in terms of the quality of communication strategies. Thirdly, the study attempts to figure out the risk communication to cope with MERS through the applications of SMCRE model in chronological order. We employ the social amplification of risk framework for analyzing the emergent public response as one of the main approaches. Research Design, Data and Methodology - The main framework of this study is theoretically based on the social amplification of risk, which describes signals about risk transmitted and processed by individuals and social groups. The model also reflects the interactions between social groups and institutes about disaster-related risk issues, which are potential amplifiers or attenuators of communication signals. S-M-C-R-E Model is methodologically employed to examine the social amplification for MERS risk information in each period, which we defined operationally. The proposed methodology allows the assessment of effectiveness and ineffectiveness on risk communication to be conceptualized as a countermeasure against disasters. The paper focuses on exploring how social risk amplification can be applied and organized in each stage. Results - The SMCRE model describes the exchange of risk information and is also applied to all forms of communication between stakeholders including public health authority, local government and media. Each factor of risk communication includes source, message, channel, receiver and effect. The results support that the effective risk communication involves not only the improved reliability of public health authority as a key factor of risk communication, but also a close cooperation and good collaboration with local governments. It does not seem to be possible that the government-initiated risk communication based on controllability and management cope effectively with infectious disease in early stage. The results of this study imply that the shared risks between local, regional and national authorities can enhance risk communication system. Conclusions - The study supports that the disparities in how disaster-related risk information is interpreted and coded, have made effective risk communication and public sense-making impeded. Our findings support a more communicative discussion about the role of risk information sharing between governments for the improvement of emergency management and underline the importance of social elements in the risk communication, such as relationship and trust building. Findings suggest that trust building between stakeholders could be added to help explain the processes of social amplification and attenuation of risk. It would be recommended that the continuous risk communication with all the involved stakeholders will be able to help national health promotion policy to be improved regarding emergency management. Furthermore, risk communication has to be a scientific approach for the communication pertaining to potentially sensitive or controversial situations with public concerns and low public trust.
Background: Regional Cardiocerebrovascular Centers (RCC) were established for the prevention and treatment of cardiocerebrovascular disease and funded by the Ministry of Health and Welfare. The purpose of this study was to develop and validate the measurement tool of public benefits in RCC. Methods: Through the intensive literature review, experts surveys and their repetitive feedback, we selected the 46 items about the public benefits in RCC. Development of measurement tool involved content validity test using Content Validity Index (CVI), construct validity test through factor analysis and reliability test. Results: Thirty-five items were selected by content validity test, which CVI was 0.08 or higher. Through the construct validity test, 32 items in 7 factors were derived. And Cronbach's alpha was 0.951. Finally, public benefits measurement tool is composed of 32 items in 7 factors which are comprehensiveness of health care services, market complement, emergency care, cost, governance, quality improvement, and government control. Conclusion: Though we developed the measurement tool of public benefits in RCC, it would be utilized to measure the public benefits of various health agencies.
Purpose: The purpose of this study is to investigate the impact of job stress, self-efficacy and empowerment of 119 Emergency medical technicians in Jeollanam-do. Methods: This study used the data collected from 346 respondents working for first aid in a fire station. To answer research questions, this study employed frequency analysis, reliability test, F (t)-test, ANOVA, Scheffe' post-hoc test, and multiple-regression analysis. Results: In terms of demographic characteristics, marital status and age had significant impact on job stress, but sex and education did not. In terms of job characteristics, first placement, rank, and tenure made significant difference on job stress, whereas certificate, department, and area did not. These results address that general characteristics, self-efficacy and job stress are critical variables on empowerment. Conclusion: From the research findings, it is concluded that fire fighters' job stress can be reduced if professional development programs are given to them, which is likely to provide better public services such as first aids and welfare, as well as to increase job satisfaction.
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