Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.
The Journal of Korean Society for School & Community Health Education
/
v.12
no.2
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pp.113-127
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2011
Background: University health services have provided comprehensive medical care, counseling, health promotion, and public health services to their students and several other local institutions. To their faculty and staff, university health care centers have served occupational health services and employee assistant program. Purpose: We performed this study to review the health promotion services on two kinds of health care center with different style of university formate. Methods: We tried to collect the data by literature review and interview with executive and provider at health care center in University of California at Berkeley and San Jose State University. Results: Our results were as followed. First, students could use the medical services just as they would their regular doctor's office and urgent care center. Second, the health promotion unit offered programs and services for keeping students healthy and safe, including many opportunities for students to get involved in shaping the public health of the campus. Third, the health promotion recommendation offered from ACHA was useful guideline to improve health status of their member in university campus. Finally, the student satisfaction surveys were used for evaluation and quality improvement. Conclusions: The systematic approach to improve health status of students, faculty and staff can use to maintain a state of optimum health among the diverse student community in support of academic excellence. Coupled with health promotion and public health programs, university health service have to reach all segments of the healthy campus community. To achieve study goals in university, the health care center contributes to promote accountability and responsibility for the health and well being of the members in their campus.
Purpose : This study is equivalence experiment performed to test practice effects between experimental group from both left and right direction of mannequin and control group having practice from only right direction in cardiopulmonary resuscitation education. Methods : Subject of the research were total 71 elementary and middle school teachers in J province who had not experience to have cardiopulmonary resuscitation. They were divided into experimental group of 35 participants who practiced cardiopulmonary resuscitation from both right and left direction of mannequin on Dec. 27, 2009 and control group of 36 participants who performed cardiopulmonary resuscitation from only right direction of mannequin on Dec. 28, 2009. Collected data were analyzed by SPSS/PC+(version 14.0). Results : 1. There was no statistically significant difference by sex among general characteristics of the subjects. 2. According to the quality of chest compression performed from the right direction of mannequin, experimental group showed better results in proper depth (time), insufficient depth (time), too lowered compression position (time) and inexact position (time) than control group(p<.05). In the quality of chest compression from the left side of mannequin, experimental group performed better results in proper depth (time), insufficient depth (time), inexact compression position (time) and mean chest compression depth(mm) than control group(p<.05) and also in more left-centered compression position (time) than control group(p<.001). 3. The quality of chest compression by experimental group, the right side of mannequin was superior in proper depth (time) to the left side of mannequin (p<.001) and showed better results in insufficient depth (time) and chest compression/recoil rate (p<.05). According to the quality of chest compression by control group, the right side of mannequin showed superior results in proper depth (time), insufficient depth (time), too left-centered compression position (time) and mean chest compression depth (mm) (p<.05) to the left side of mannequin. Conclusion : The group having practice from both right and left sides of mannequin was superior in the quality of chest compression to the group having practice from only right side of mannequin. How to practice cardiopulmonary resuscitation from both right and left sides of mannequin can be recommended and practice from left side of mannequin is also useful.
Shin, Dong-Min;Jang, Mun-Sun;Kang, Bo-Ra;Yoon, Byeung-Gil;Tak, Yang Ju;Lee, In-Soo
The Korean Journal of Emergency Medical Services
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v.14
no.3
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pp.95-105
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2010
Purpose: This study aims to investigate the operation of continuing education system and continuing education program for emergency medical technician in Korea, Japan and United States and develop reasonable operating scheme of continuing education and curriculum in order to provide the base data for the improvement of continuing education for the improved practice capability and its maintenance, Method: The overall review of continuing education for domestic 1st class emergency medical technician was performed and also the content of continuing education for Emergency Medical Technician - Paramedic in the United States and Paramedics of Fire Department with the license for the paramedic in Japan, have been analyzed through literature, books, articles, agencies' data, laws, and internet date. Result: Hours for domestic continuing education was 4-8 hours and it was only 3-11% compared to 72 hours in the United States and 128 hours in the Japan. And with respect to the types and methods of programs, there were differences both in quantity and quality. Conclusion: As an education, providing and supplementing the changed content and technical information for the improvement of the capability and qualification of emergency medical technician, selection of education hours and various continuing education should be continuously and regularly provided and conducted. The introduction of various continuing education system and programs for this is considered to be required.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.4
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pp.340-350
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2016
The Medical Service Act of Korea describes a clinic as providing services primarily to outpatients, while a large general hospital provides specialized medical services requiring a high level of expertise for treating serious diseases. The portion of medical revenue for clinics has been decreasing gradually compared with large hospitals. This article proposes two fundamental medical policies to fix the distorted medical delivery system of Korea. Firstly, uniform additional medical remuneration rates based on the type of medial institution should be divided into outpatient additional rates and inpatient additional rates. Secondly, to normalize the function of clinics and large general hospitals, an outpatient medical target budget system should be introduced. Finally, to properly implement the proposal, it is important to establish healthcare policy-making governance. The success of policy implementation strongly depends on the participation and incentives of the government, suppliers, and patients. Healthcare policy-making governance must be designed to encompass this fact and improve quality of care.
The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.
The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.
The healthcare industry, a high-value-added business, continues to grow with the aging of the population and the development of convergence medical technology. In particular, the medical tourism industry is being pushed by advanced countries. Korea is also actively supporting projects to attract international patients. However, there is a lack of prior research on Korea's medical interpreter policy. This study analyzes the current status and problems of medical interpreter policy for international patients, and presents the task. Problems include insufficient policy control towers, lack of links with local governments, lack of expertise of medical interpreters, poor quality of medical interpreting services, and poor treatment of medical interpreters. As improvement measures, it is proposed to establish a policy control tower, strengthen the link with local governments, switch to a medical interpreter system, diversify the language of medical interpreting qualification test, improve the quality of medical interpreting service, internalize the training process for medical interpreter, give preferential treatment to medical interpreters, utilize the nurse, and train multicultural medical personnel. I hope that this study will contribute to the development of the medical tourism industry.
This study analyzed the teaching and learning support web services of health-specialized colleges. It was searched for educational innovation and teaching and learning support on the portal site. Web services related to teaching and learning at eight health-specialized colleges were classified into five categories. CTL web service support, teaching support, learning support, CTL introduction, and differentiated web services were analyzed. Teaching and learning support and CTL introduction web services were subdivided and operated, and web services that increased access to teaching and learning support were provided to teachers and students by preparing for national exams. Students at health-specialized colleges must pass the national examination to get a job, and the quality of teaching and learning needs to be improved. Therefore, the excellence of providing teaching and learning programs is required for junior college teachers and students. Based on this study, it is expected to improve the quality of web services for teaching and learning support in specialized health colleges.
Purpose: This study was to identify health behavior, health service use, and health related quality of life of adult women in one-person and multi-person households. Methods: It was used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-2017). Subjects were 2,522 women with age of 19 to 64 years in 2017. Complex sampling design and data analysis were performed using SPSS 20.1. Results: Women in one-person households had higher rates of alcohol drinking (${\chi}^2=13.77$, p=.003), smoking (${\chi}^2=16.07$, p=.001), unmet medical care (${\chi}^2=8.77$, p=.004) and non-practice of cancer screening (${\chi}^2=13.77$, p=.003) compared to women in multi-person households. Health-related quality of life was also lower for women in one-person households (t=-2.46, p=.015). Factors affecting health-related quality of life in one-person households were household income, job status, and unmet dental care, having 32.4% explanatory power. One-person household women with low incomes, no jobs, and unmet dental care showed low health-related quality of life. In comparison, factors affecting health-related quality of life of women in multi-person household women were age, education level, unmet medical care, and unmet dental care, having 10.4% explaining power. Women in multi-person households with age of 60-64, low education level, unmet medical care, and unmet dental care showed low health-related quality of life. Conclusion: Health promotion strategies should be developed based on unique understanding of social, economic, and health of adult women in one-person and multi-person households.
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