Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.
This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, admission procedure, hospital image, service quality of physicians that patients perceived. For inpatients, hospital image and service quality of medical technicians have an effect on perceived value. Service quality of physicians has an effect on the patient satisfaction. For outpatients, hospital image and service quality of physicians and medical technicians have an effect on perceived value. Outdoor environment, hospital image, service quality of physicians and medical technicians, and perceived value have an effect on patient satisfaction. Perceived value and patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve specialty hospitals.
Due to the development of information and communication technology as health care service is popular variety utilizing bioinformatics patient information services are being provided to the patient. In particular, the healthcare utilizing bioinformatics information, and change in a variety of healthcare trends. However, healthcare services using bioinformatics information of the patient and the complexity of the disease, new diseases (SARS, AIDS, etc .) due to the emergence of increasing health care costs and health promotion services provided to patients may not be smooth. In this paper, we propose a model for low-cost health services and medical care of patients bioinformatics fast access to information. The proposed model can be so big a bioinformatics data formation by the patient's patient information anytime / anywhere providing medical services in the home or the nearest hospital for their own disease management. In particular, the proposed model of health care services is characterized improve work efficiency, reducing the burden on hospitals by passing a medical illness to easily analyze patient information.
This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.
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.
The purpose of this research which was conducted by surveying the transfer consultation records from 360 medical institutions such as general hospitals, hospitals, clinics to the Emergency Medical Center at E University Hospital for six months(Jan. 1, 2000 - Jun. 30, 2000) are to standardize & complete transfer consultation record of hospitals at the 1st & 2nd referral level and to give patients transferred emergency medical center medical information services on a better quality. The conclusions and suggestions from this study were summarized as follows; (1) Examing the distribution of the referral medical consultation(transfer) sheet type, surgery part local clinic sheet types were 34.4%, medical part local clinic sheet types were 26.7%, undifferentiated local clinic sheet types were 23.9% and hospital level sheet types were 15.0%. (2) The items of the transfer consultation records had been standardized more than 75% in the order of patient's name, date, doctor's name, diagnosis, patient's status, impressions. (3) That the degree of recording completion on these items is in the order of patient's name, date, diagnosis, impressions was revealed. (4) Because the standardization and the degree of recording completion are very low in the patient's gender, age, address, electronic recording system was needed for more perfect input of initial patient informations. (5) This standardizing & complete recording on examination and medication will prevent re-examination and abuse of medication for patients transferred emergency medical center. (6) EMT Transfer System should be fixed in all medical institute for the standardizing & complete recording on care period and departure time will give many emergency patients the proper treatments at the proper time. (7) It was revealed that developing new standardized transfer consultation record & using electronic recording system are needed. (8) The complete recording & Fast Track System were needed for higher rate of bed operation at emergency medical center and more hospital profit.
Purpose: By analyzing the health status of emergency patients on islands in the Jeollanam-do province, this study aims to provide basic data for proposed future medical emergency services on the islands. This information includes monthly and hourly statistics on patients' characteristics, patient frequency, an analysis of first aid procedures, response times, and time spent at hospitals. Methods: The study analyzed the monthly and hourly frequency of emergency patients, first aid status and procedures, general patient characteristics, accident types, patient cognitive status and agility, marine police response times, and frequency and percentile of hospital dispatch times. Results: 1Q and #q show the highest patient turnover rate in one year. 50.5% of daily patients are admitted between 4 PM and 12 PM. The hospital dispatch time is within a one- to two-hour window for 54.0% of all patients. Conclusion: The emergency medical service system for the Jeollanam-do province islands and seas is available to all Korean residents, citizens, and visitors. It is necessary to implement an emergency medical system for the relevant organizations.
As a patient has recently been recognized as not a passive object but a subject of medical services, various attempts are being made to strengthen the status of a patient. Medical communication which has been led by a doctor so far is being made with a focus on a patient due to sovereignty of a consumer and activation of medical information. The purpose of this paper is to investigate the process to strengthen the status of a patient as a consumer of health care service through a patient association and consumer movement as medical information becomes public. As the patient centered medical service is creating a variety of health care service market using IT technologies, it has contributed to the improvement on asymmetry of medical information. As the expansion of IT fusion health care market is bringing the fundamental change into the traditional relationship between a doctor and a patient, the medical service market is being re-organized. A patient centered medical service such as expansion of mobile health care model led by a patient is being accelerated.
Purpose: This study was conducted to investigate the disaster response competencies of 119 emergency medical technicians (EMTs). Methods: The subjects of this study were 226 119 EMT's at the fire station located in G province. The questionnaire consisted of 5 sub-factors and 29 items for measuring disaster response competencies and the collected data were analyzed using SPSS program. Results: Disaster response competency comprising immediate response, patient triage, patient treatment, patient transport, and collaboration support were 3.48, 3.64, 3.52, 3.64, and 3.16, respectively. Advanced EMTs scored significantly higher in patient triage (p<.001), treatment (p<.001), and transport (p=.022) competency than basic EMTs. Conclusion: In order to improve disaster response competency, it is necessary not only to enhance individual ability but also to continue disaster management training with related organizations.
With the recent establishment of a ubiquitous-based medical and healthcare environment, the medical information system for obtaining situation information from various sensors is increasing. In the medical information system environment based on context-awareness, the patient situation can be determined as normal or emergency using situational information. In addition, medical staff can easily access patient information after simple user authentication using ID and Password through applications on smart devices. However, these services of authentication and patient information access are staff-oriented systems and do not fully consider the ubiquitous-based healthcare information system environment. In this paper, we present a authentication service model based context-awareness system for providing situational information-driven authentication services to users who access medical information, and implemented proposed system. The authentication service model based context-awareness system is a service that recognizes patient situations through sensors and the authentication and authorization of medical staff proceed differently according to patient situations. It was implemented using wearables, biometric data measurement modules, camera sensors, etc. to configure various situational information measurement environments. If the patient situation was emergency situation, the medical information server sent an emergency message to the smart device of the medical staff, and the medical staff that received the emergency message tried to authenticate using the application of the smart device to access the patient information. Once all authentication was completed, medical staff will be given access to high-level medical information and can even checked patient medical information that could not be seen under normal situation. The authentication service model based context-awareness system not only fully considered the ubiquitous medical information system environment, but also enhanced patient-centered systematic security and access transparency.
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