• Title/Summary/Keyword: Policy Enforcement

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A Study on Minimum Cabin Crew Requirements for Korean Low Cost Air Carriers

  • Yoo, Kyung-In;Kim, Mun-Kyung
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.291-314
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    • 2018
  • In recent 3 years, Korea's low-cost airlines have expanded their areas of passenger transportation not only to domestic market but also to Japan, China, Southeast Asia and US territory as a total of 6 companies (8 airlines including small air operation business carriers). Currently, three more airlines have filed for air transportation business certification as future low-cost carriers, and this expansion is expected to continue. To cope with the aggressive airline operations of domestic and foreign low-cost carriers and to enhance their competitiveness, each low-cost airline is taking a number of strategies for promoting cabin service. Therefore, the workload of the cabin crew is increased in proportion to the expansion, and the fatigue directly connected with the safety task performance is increased. It is stipulated in the Enforcement Regulations of the Korea Aviation Safety Act that at minimum, one cabin crew is required per 50 passenger seating capacity, and all low cost carriers are boarding only the minimum cabin crew. Sometimes it is impossible for them to sit in a floor level emergency exit for evacuation, which is the main task of the cabin crew, and this can cause confusion among evacuating passengers in the event of an emergency. In addition, if one of the minimum cabin crew becomes incapacitated due to an injury or the like, it will become a serious impediment in performing emergency evacuation duties. Even in the normal situation, since it will be violating the Act prescription on the minimum cabin crew complement, passengers will have to move to another available airline flights, encountering extreme inconvenience. Annex 6 to the Convention on International Civil Aviation specifies international standards for the determination of the minimum number of cabin crew shall be based only on the number of passenger seats or passengers on board for safe and expeditious emergency evacuation. Thereby in order to enhance the safety of the passengers and the crew on board, it is necessary to consider the cabin crew's fatigue that may occur in the various job characteristics (service, safety, security, first aid)and floor level emergency exit seating in calculating the minimum number of cabin crew. And it is also deemed necessary for the government's regulatory body to enhance the cabin safety for passengers and crew when determining the number of minimum cabin crew by reflecting the cabin crew's workload leading to their fatigue and unavailability to be seated in a floor level emergency exit on low cost carriers.

A Study on Major Safety Problems and Improvement Measures of Personal Mobility (개인형 이동장치의 안전 주요 문제점 및 개선방안 연구)

  • Kang, Seung Shik;Kang, Seong Kyung
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.202-217
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    • 2022
  • Purpose: The recent increased use of Personal Mobility (PM) has been accompanied by a rise in the annual number of accidents. Accordingly, the safety requirements for PM use are being strengthened, but the laws/systems, infrastructure, and management systems remain insufficient for fostering a safe environment. Therefore, this study comprehensively searches the main problems and improvement methods through a review of previous studies that are related to PM. Then the priorities according to the importance of the improvement methods are presented through the Delphi survey. Method: The research method is mainly composed of a literature study and an expert survey (Delphi survey). Prior research and improvement cases (local governments, government departments, companies, etc.) are reviewed to derive problems and improvements, and a problem/improvement classification table is created based on keywords. Based on the classification contents, an expert survey is conducted to derive a priority improvement plan. Result: The PM-related problems were in 'non-compliance with traffic laws, lack of knowledge, inexperienced operation, and lack of safety awareness' in relation to human factors, and 'device characteristics, road-drivable space, road facilities, parking facilities' in relation to physical factors. 'Management/supervision, product management, user management, education/training' as administrative factors and legal factors are divided into 'absence/sufficiency of law, confusion/duplication, reduced effectiveness'. Improvement tasks related to this include 'PM education/public relations, parking/return, road improvement, PM registration/management, insurance, safety standards, traffic standards, PM device safety, PM supplementary facilities, enforcement/management, dedicated organization, service providers, management system, and related laws/institutional improvement', and 42 detailed tasks are derived for these 14 core tasks. The results for the importance evaluation of detailed tasks show that the tasks with a high overall average for the evaluation items of cost, time, effect, urgency, and feasibility were 'strengthening crackdown/instruction activities, education publicity/campaign, truancy PM management, and clarification of traffic rules'. Conclusion: The PM market is experiencing gradual growth based on shared services and a safe environment for PM use must be ensured along with industrial revitalization. In this respect, this study seeks out the major problems and improvement plans related to PM from a comprehensive point of view and prioritizes the necessary improvement measures. Therefore, it can serve as a basis of data for future policy establishment. In the future, in-depth data supplementation will be required for each key improvement area for practical policy application.

A Study on Policy-making, Leadership and Improvement of Professionalism for Audiovisual Archives Management in Korea (국내 시청각 기록관리 정책 리더십 및 전문성 제고 방안 연구)

  • Choi, Hyo jin
    • The Korean Journal of Archival Studies
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    • no.72
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    • pp.91-163
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    • 2022
  • The focus of this paper lies on the fact that the 'management' and 'utilization' of audiovisual archives are still not specialized in both the public and the private sectors. The use of online video platforms including 'YouTube' has became common. Accordingly the production and collection of high-definition and high-capacity audiovisual archives has been rapidly increasing. However, it also emphasizes that there are no references or principles in the current Public Records Act and its enforcement rules, public standards, and guidelines. This paper ultimately examines the provisions that are related to audiovisual archives of the current Public Records Act, which needed to be revised and enacted due to the lack of an audiovisual archives management manual of national institutions, public broadcasters, and organizations can refer to. In addition, this study tries to find out what kind of systems and guidelines are used in audiovisual archives management. This paper examines the current state of standardization of audiovisual records of the National Archives. It also analyses the systems and the guidelines methodically for efficient audiovisual record management in the public records management sector. It suggests the new direction of relevant public standards and guidelines through this research. Futhermore, it measures to activate the audiovisual management policy-making functions of the National Archives. The necessity of establishing a Public Audiovisual Archives as an organization was also reviewed in this paper. The Public Audiovisual Archives will collect Public Audio and Videos systematically and comprehensively through the legal deposit system. And it will be operated by the management and the utilization system so that it can be used for public as a collective memory. Finally, it will takes a charge of a professional role in audiovisual record management field, such as technology standardization to safeguard and protect the copyrights through this process.

Policy Direction for The Farmland Sizing Suitable to Regional Trait (지역특성을 반영한 영농규모화사업의 발전방향-충남지역을 중심으로-)

  • Shim, Jae-Sung
    • The Journal of Natural Sciences
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    • v.14 no.1
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    • pp.83-121
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    • 2004
  • This study was carried out to examine how solid the production foundation of rice in Chung-Nam Province is, and, if not, to probe alternative measures through the size of farms specializing in rice, of which direction would be a pivot of rice industry-oriented policy. The results obtained can be summarized as follows : 1. The amount of rice production in Chung-Nam Province is highest in Korea and the size of paddy field area is the second largest : This implying that the probability that rice production in Chung-Nam Province would be severely influenced by a global trend of market conditions. The number of farms specializing in rice becoming the core group of rice farming account for 7.7 percent of the total number of farm household in Korea. Average field area financial support which had been input to farm household by Government had a noticeable effect on the improvement of the policy of farm-size program. 2. Farm-size program in Chung-Nam Province established from 1980 to 2002 in creased the cultivation size of paddy field to 19,484 hectares, and this program enhanced the buying and selling of farmland and the number of farmland bargain reached 6,431 household and 16,517 hectares, respectively, in 1995-2002. Meanwhile, long-term letting and hiring of farmland appeared so active that the bargain acreage reached 6,970 hectares, and farm involved was 7,059 households, however, the farm-exchange-and-unity program did not satisfy our expectation, because the retirement farm operators reluctantly participated to sell their farms. Another reason that had delayed the bargain of farms rested on the general category of social complication attendant upon the exchange and unity operation for scattered farm. Such difficulties would work negative effects out to carry on the target of farm-size work in general. 3. The following measures were presented to propel the farm-size promotion program : a. Occupation shift project, followed by the social security program for retirement and elderly farm operators, should be promptly established and also a number of types of incentives for promoting the letting and hiring work and farm-exchange-and-unity program would also be set up. b. To establish the effective key system of rice production, all the farm operators should increase the unit area yield of rice and lower the production cost. To do so, a great deal of production teams of rice equipped with managerial techniques and capabilities need to be organized. And, also, there should be appropriate arrays of facilities including information system. This plan is desirable to be in line with a diversity of the structural implement of regional integration based on farm system building. c. To extend the size of farm and to improve farm management, we have to devise the enlargement of individual size of farm for maximized management and the utilization of farm-size grouping method. In conclusion, it can be said that the farm-size project in Chung-Nam Province which has continued since the 1980s was satisfactorily achieved. However, we still have a lot of problems to be solved to break down the barrier for attainment of the desirable farm-size operation work.. Farm-size project has fairly close relation with farm specialization in rice and, thus, the positive support for farm household including the integrated program for both retirement farmers and off-farm operators should be considered to pursue the progressive development of the farm-size program, which is key means to successful achievement of rice farming enforcement in Chung-Nam Province.

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A Study on the Legal Proposal of Crew's Fatigue Management in the Aviation Regulations (항공법규에서의 승무원 피로관리기준 도입방안에 관한 연구 - ICAO, FAA, EASA 기준을 중심으로 -)

  • Lee, Koo-Hee;Hwang, Ho-Won
    • The Korean Journal of Air & Space Law and Policy
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    • v.27 no.1
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    • pp.29-73
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    • 2012
  • Aviation safety is the State and industry's top priority and more scientific approaches for fatigue management should be needed. There are lately various studies and regulation changes for crew fatigue management with ICAO, FAA and EASA. ICAO issued the provisions of fatigue management for flight crew since 1st edition, 1969, of Annex 6 operation of aircraft as a Standards and Recommended practice(SARPs). Unfortunately, there have been few changes and improvement to fatigue management provisions since the time they were first introduced. However the SARPs have been big changed lately. ICAO published guidance materials for development of prescriptive fatigue regulations through amendment 33A of Annex 6 Part 1 as applicable November 19th 2009. And then ICAO introduced additional amendment for using Fatigue Risk Management System (FRMS) with $35^{th}$ amendment in 2011. According to the Annex 6, the State of the operator shall establish a) regulations for flight time, flight duty period, duty period and rest period limitations and b) FRMS regulations. The Operator shall implement one of following 3 provisions a) flight time, flight duty period, duty period and rest period limitations within the prescriptive fatigue management regulations established by the State of the Operator; or b) a FRMS; or c) a combination of a) and b). U.S. FAA recently published several kinds of Advisory Circular about flightcrew fatigue. U.S. passed "Airline Safety and FAA Extension Act of 2010" into law on August 1st, 2010. This mandates all commercial air carriers to develop a FAA-acceptable Fatigue Risk Management Plan(FRMP) by October 31st, 2010. Also, on May 16, 2012, the FAA published a final rule(correction) entitled 'Flightcrew Member Duty and Rest Requirements; correction to amend its existing prescriptive regulations. The new requirements are required to implement same regulations for domestic, flag and supplemental operations from January 4, 2014. EASA introduced a Notice of Proposed Amendment (NPA) 2010-14 entitled "Draft opinion of the European Aviation Safety Agency for a Commission Regulation establishing the implementing rules on Flight and Duty Time Limitations and Rest Requirements for Commercial Air Transport with aeroplanes" on December 10, 2010. The purpose of this NPA is to develop and implement fatigue management for commercial air transport operations. Comparing with Korean and foreign regulations regarding fatigue management, the provisions of ICAO, FAA, EASA are more considering various fatigue factors and conditions. Korea regulations should be needed for some development of insufficiency points. In this thesis, I present the results of the comparative study between domestic and foreign regulations in respect of fatigue management crew member. Also, I suggest legal proposals for amendment of Korea Aviation act and Enforcement Regulations concerning fatigue management for crew members. I hope that this paper is helpful to change korea fatigue regulations, to enhance aviation safety, and to reduce the number of accidents relating to fatigue. Fatigue should be managed at all level such as regulators, experts, operators and pilots. Authority should change surveillance mind-set from regulatory auditor to expert adviser. Operators should identify various fatigue factors and consider to crew scheduling them. Crews should strongly manage both individual and duty-oriented fatigue issues.

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Regional Development And Dam Construction in Korea (한국의 지역개발과 댐건설)

  • 안경모
    • Water for future
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    • v.9 no.1
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    • pp.38-42
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    • 1976
  • Because of differences in thoughts and ideology, our country, Korea has been deprived of national unity for some thirty years of time and tide. To achieve peaceful unification, the cultivation of national strength is of paramount importance. This national strength is also essential if Korea is to take rightful place in the international societies and to have the confidence of these societies. However, national strength can never be achieved in a short time. The fundamental elements in economic development that are directly conducive to the cultivation of national strength can be said to lie in -a stable political system, -exertion of powerful leadership, -cultivation of a spirit of diligence, self-help and cooperation, -modernization of human brain power, and -establishment of a scientific and well planned economic policy and strong enforcement of this policy. Our country, Korea, has attained brilliant economic development in the past 15 years under the strong leadership of president Park Chung Hee. However, there are still many problems to be solved. A few of them are: -housing and home problems, -increasing demand for employment, -increasing demand for staple food and -the need to improve international balance of payment. Solution of the above mentioned problems requires step by step scientific development of each sector and region of our contry. As a spearhead project in regional development, the Saemaul Campaign or new village movement can be cited. The campaign is now spreading throughout the country like a grass fire. However, such campaigns need considerable encouragement and support and the means for the desired development must be provided if the regional and sectoral development program is to sucdceed. The construction of large multipurpose dams in major river basin plays significant role in all aspects of national, regional and sectoral development. It ensures that the water resource, for which there is no substitute, is retained and utilized for irrigation of agricultural areas, production of power for industry, provision of water for domestic and industrial uses and control of river water. Water is the very essence of life and we must conserve and utilize what we have for the betterment of our peoples and their heir. The regional and social impact of construction of a large dam is enormous. It is intended to, and does, dras tically improve the "without-project" socio-economic conditions. A good example of this is the Soyanggang multipurpose dam. This project will significantly contribute to our national strength by utilizing the stored water for the benefit of human life and relief of flood and drought damages. Annual average precipitation in Korea is 1160mm, a comparatively abundant amount. The catchment areas of the Han River, Keum River, and Youngsan River are $62,755\textrm{km}^2$, accounting for 64% of the national total. Approximately 62% of the national population inhabits in this area, and 67% of the national gross product comes from the area. The annual population growth rate of the country is currently estimated at 1.7%, and every year the population growth in urban area increases at a rising rate. The population of Seoul, Pusan, and Taegu, the three major cities in Korea, is equal to one third of our national total. According to the census conducted on October 1, 1975, the population in the urban areas has increased by 384,000, whereas that in rural areas has decreased by 59,000,000 in the past five years. The composition of population between urban and rural areas varied from 41%~59% in 1959 to 48%~52% in 1975. To mitigate this treand towards concentration of population in urban areas, employment opportunities must be provided in regional and rural areas. However, heavy and chemical industries, which mitigate production and employment problems at the same time, must have abundant water and energy. Also increase in staple food production cannot be attained without water. At this point in time, when water demand is rapidly growing, it is essential for the country to provide as much a reservoir capacity as possible to capture the monsoon rainfall, which concentarated in the rainy seaon from June to Septesmber, and conserve the water for year round use. The floods, which at one time we called "the devil" have now become a source of immense benefit to Korea. Let me explain the topographic condition in Korea. In northern and eastern areas we have high mountains and rugged country. Our rivers originate in these mountains and flow in a general southerly or westerly direction throught ancient plains. These plains were formed by progressive deposition of sediments from the mountains and provide our country with large areas of fertile land, emminently suited to settlement and irrigated agricultural development. It is, therefore, quite natural that these areas should become the polar point for our regional development program. Hower, we are fortunate in that we have an additional area or areas, which can be used for agricultural production and settlement of our peoples, particularly those peoples who may be displaced by the formation of our reservoirs. I am speaking of the tidelands along the western and southern coasts. The other day the Ministry of Agriculture and Fishery informed the public of a tideland reclamation of which 400,000 hectares will be used for growing rice as part of our national food self-sufficiency programme. Now, again, we arrive at the need for water, as without it we cannot realize this ambitious programme. And again we need those dams to provide it. As I mentioned before, dams not only provide us with essential water for agriculture, domestic and industrial use, but provide us with electrical energy, as it is generally extremely economical to use the water being release for the former purposes to drive turbines and generators. At the present time we have 13 hydro-electric power plants with an installed capacity of 711,000 kilowatts equal to 16% of our national total. There are about 110 potential dams ites in the country, which could yield about 2,300,000 kilowatts of hydro-electric power. There are about 54 sites suitable for pumped storage which could produce a further 38,600,000 kilowatts of power. All available if we carefully develop our water resources. To summarize, water resource development is essential to the regional development program and the welfare of our people, it must proceed hand-in-hand with other aspects of regional development such as land impovement, high way extension, development of our forests, erosion control, and develop ment of heavy and chemical industries. Through the successful implementation of such an integrated regional development program, we can look forward to a period of national strength, and due recognition of our country by the worlds societies.

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A Study on the Passengers liability of the Carrier on the Montreal Convention (몬트리올협약상의 항공여객운송인의 책임(Air Carrier's Liability for Passenger on Montreal Convention 1999))

  • Kim, Jong-Bok
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.31-66
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    • 2008
  • Until Montreal Convention was established in 1999, the Warsaw System is undoubtedly accepted private international air law treaty and has played major role on the carrier's liability in international aviation transport industry. But the whole Warsaw System, though it was revised many times to meet the rapid developments of the aviation transport industry, is so complicated, tangled and outdated. This thesis, therefore, aim to introduce the Montreal Convention by interpreting it as a new legal instrument on the air carrier's liability, specially on the passenger's, and analyzing all the issues relating to it. The Montreal Convention markedly changed the rules governing international carriage by air. The Montreal Convention has modernized and consolidated the old Warsaw System of international instruments of private international air law into one legal instrument. One of the most significant features of the Montreal Convention is that it sifted its priority to the protection of the interest of the consumers from the protection of the carrier which originally the Warsaw Convention intended to protect the fledgling international air transport business. Two major features of the Montreal Convention adopts are the Two-tier Liability System and the Fifth Jurisdiction. In case of death or bodily injury to passengers, the Montreal Convention introduces a two-tier liability system. The first tier includes strict liability up to 100,000SDR, irrespective of carriers' fault. The second tier is based on presumption of fault of carrier and has no limit of liability. Regarding Jurisdiction, the Montreal Convention expands upon the four jurisdiction in which the carrier could be sued by adding a fifth jurisdiction, i.e., a passenger can bring suit in a country in which he or she has their permanent and principal residence and in which the carrier provides a services for the carriage of passengers by either its own aircraft or through a commercial agreement. Other features are introducing the advance payment, electronic ticketing, compulsory insurance and regulation on the contracting and actual carrier etc. As we see some major features of the Montreal Convention, the Convention heralds the single biggest change in the international aviation liability and there can be no doubt it will prevail the international aviation transport world in the future. Our government signed this Convention on 20th Sep. 2007 and it came into effect on 29th Dec. 2007 domestically. Thus, it was recognized that domestic carriers can adequately and independently manage the change of risks of liability. I, therefore, would like to suggest our country's aviation industry including newly-born low cost carrier prepare some countermeasures domestically that are necessary to the enforcement of the Convention.

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Fundamental research to investigate methods of vocational competency enforcement in field of home economics education - revision of the current NCS based vocational highschool education curriculum and investigation in change of direction in vocational home economics education - (가정과교육에서의 직업역량 강화 방안 탐색을 위한 기초 연구 - NCS 기반 고교 직업교육과정 개정과 가사실업계 직업교육의 변화 방향 탐색 -)

  • Jang, Myung Hee
    • Journal of Korean Home Economics Education Association
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    • v.26 no.4
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    • pp.129-146
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    • 2014
  • This study is a fundamental research in the field of home economics education to enforce vocational competencies. It was carried out in the purpose of examining the recent economical and social environmental changes and its management system related to the vocational training in the field of home economics education. It seeks change in direction in relation to the National Competency Standard(NCS) based on revisions in the educational system. The method of study was mostly through reference and data analysis, professional advisory and public hearing. The main research results are as follows. First, the main environmental change factors in relation to vocational training have been integrated to the changes in; population structure, gender related economic activities, generation composition, communications technology, and innovation of living technique. These change factors are forecasting innovations in related industries, lifestyle changes, demand for manpower and changes in capabilities required for each specific profession. Second, according to the analysis of current home economics education training, vocational home educations high school accounts for 9.4% of the total number of specialized high schools, where 8 standard departments are specialized in and characterized into 137 different department names. Despite differences among departments, overall employment rate of graduates were measured 44.7%, which rates above the entrance rate of 41.9%. These numbers show great change since 2010(overall employment rate 16.9%, entrance rate 75.2%), a meaningful outcome resulting from changes in policy from the previous employment-centered education system. Third, NCS based on high school vocational home economics education system revision and investigations in change of direction in vocational home economics, this study attempts to provide background for revision from the development of NCS. It also provides proposals for restructuring division of current classification and departments of home economics education, and propositions for further future research.

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Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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