In the past, there has not been a law with the main purpose of preventing or preventing a risk in advance in order to protect the safety of patients in relation to medical services. It is evaluated that the enactment of the Patient Safety Act has a very important meaning in protecting patient safety as the top priority and further improving the quality of medical care. However, looking at the status of patient safety accidents reported to the Patient Safety Reporting System after the Patient Safety Act was enacted and implemented, various types of risk factors for patient safety still exist in the medical field. Meanwhile, Korea Consumer Agency and Korea Medical Dispute Mediation and Arbitration Agency, the existing domestic ADR specialized agencies, have been operating reasonable damage relief procedures such as recommendation of settlement, mediation, and arbitration according to the purpose of their establishment. Therefore, with the aimof broadening the choice of compensation system for patients, we propose the establishment and revision of ADR-related laws to apply the damage relief procedures of both institutions.
Background : In order to recognize the problems of current Korean physical therapy which does not conform to the current trend of modern society and to suggest improvement directions, we will establish a law for exclusive use of physical therapy that can guarantee the health rights of the people and contribute to the development of Korean physical. Methods : Korea's current physiotherapy system is compared with OECD member countries and WCPT member countries, and considering the expected effects and necessities that arise when the sole law is enacted, the sole law for the global trend is presented. Result : If the sole law is enacted and the physical therapist is treated solely, the effect is as follows. 1. Provision of high-quality physiotherapy services through establishment of physical therapy expertise 2. Convenient service provision 3. Reduced treatment costs due to reduced National Health Insurance fiscal expenditure 4. contributing to the improvement of medical welfare for the elderly and the disabled 5. Decreased unemployment rate due to job creation.
The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.
Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.
Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.
In this article, 「Act on the hospice and palliative care and decisions on life-sustaining treatment for patients at the end of life」, 「Act On The Improvement Of Mental Health And The Support For Welfare Services For Mental Patients」, 「Organs Transplant Act」, 「Safety And Management Of Human Tissue Act」, 「Pharmaceutical Affairs Act」, 「Prevention Of Acquired Immunodeficiency Syndrome Act」, 「Tuberculosis Prevention Act」, 「Infectious Disease Control And Prevention Act」 were reviewed. Patients' right to self-determination and consent in these laws are related to civil law. even though they are closely related to the civil law in relation to patients' right to self-determination and consent. In order to consistently operate medical administration, it is necessary to understand the principles of civil law decision-making.
This study investigates the distribution characteristics of medical services in Korea. For the purpose this paper examines the spatial discordance between the provisions of the medical services and the need for them, and analyzes the spatial distribution patterns of medical service in both inter- and intra-regional levels. Disclosed is a severe regional disparity problem in the provision of medical facilities at both inter-regional and intra-regional levels. In recent years people's interest gets increased more in the social well-being of the community, and the resulting strong request makes it desirable to restructure the healthcare service system. This study has thus attempted to draw out the distribution function of the medical facilities, based on the examination of the real data. A particular attention has been paid to whether there exists any hierarchical structure in their size distribution. Quite remarkably, no appreciable hierarchical structure has been observed in the scale of the medical facilities in Korea, in sharp contrast to of the three-level hierarchical structure assumed in the three-level referral system adopted widely. Remarkably, it is revealed that medical facilities in Korea are described by scale-invariant distribution functions. Instead, scale-invariant power-law behavior has been found in the size distribution, which is expected to be rather generic and applicable to other countries as well.
Purpose: This study was carried out in order to provide the basic data for the curriculum standardization of emergency medical technology by analyzing the three-year period curriculum of 9 colleges. Method: This is the descriptive analysis of the curricular of 9 colleges. The analyzed variables were the distribution, credit, mean, frequency of the liberal arts, majors, clinical and on-the-job(OJT) training courses, and teaching profession subject. Results: 1. The number of whole subjects was 61.0, the number of liberal arts was 10.3, and the number of majors was 50.7. The completion credit was 128.3, credits of liberal arts were 15.5(12.2%), and credits of majors were 112.8(87.8%). 2. The range of credits of liberal arts was 8 to 21, and most of the liberal arts were done in the first year of college. 3. The distribution of the credits of the national examination for the license was as follows; the itemized emergency care subjects were 27.9 credits, the general emergency care was 18.5 credits, basic sciences were 17.7 credits, emergency patient care was 9.5 credits, and emergency medicine law was 3.2 credits. 4. The number of other major subjects were 10.0 and showed even distribution in each semester. 5. The clinical and on-the-job(OJT) training were 4.5 subjects, the credits of completion were 14.9 and these subjects were not in the first year of college. Conclusion: This results will be helpful data for the advanced development and standardization of the new curriculum by keeping pace with the environmental change, competency improvement and the need of the learners of emergency medical technology.
Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.
Purpose: This study aimed to identify the problems and improvement areas by reviewing the laws related to kindergarden healthcare workers. Methods: The laws were searched at the Korean law information center (https://www.law.go.kr/). We reviewed the 「Early Childhood Education Act」, 「School Health Act」, 「Medical Service Act」, 「Elementary and Secondary Education Act」and their enforcement decrees and rules. Results: The legal role of health teachers as school healthcare professionals was comprehensively specified by the 「School Health Act. However, the qualifications for and roles of health teachers were not fully described in 「Early Childhood Education Act], indicating a unclear legal basis for the qualifications for and roles of kindergarten health teachers. To support healthcare workers in kindergartens, it is necessary to amend the 「Early Childhood Education Act」 that provides the guidelines for qualifications for kindergarten health teachers in elementary, secondary, and special schools who have completed necessary continuing education. A health hub kindergarten could be a step-by-step option for all kindergartens to have healthcare workers. Conclusion: This review demonstrated the importance of amending the laws on kindergarten health teachers and health hub kindergartens for child health and safety. These findings could be used to support policies related to kindergarten healthcare workers.
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