This study examines the effects of the public’s perception of emergency medical service (EMS) on the public health system’s brand equity and the moderating effect of governance on this relationship using Keller’s customer-based brand equity model. It uses four EMS functions: rescue/first-aid and transfer activities; disaster prevention, preparation, and response activities; educational activities in urgent situations; and medical treatment in emergency rooms to examine the effects of them on brand meaning of the public health system. Our findings are important for understanding the public as customers of the public health system and devising and/ or adapting healthcare policies and marketing strategies to develop brand equity and increase customers’ loyalty to the public health system.

In order to deal with high uncertainty and variability in emergency medical centers, many researchers have developed various models for their operational planning and scheduling. However, most of the models just provide static plans without any risk measures as their results, and thus the users often lose the opportunity to analyze how much risk the patients have, whether the plan is still implementable or how the plan should be changed when an unexpected event happens. In this study, we construct a simulation model combined with a risk-based planning and scheduling module designed by Simio LLC. In addition to static schedules, it provides possibility of treatment delay for each patient as a risk measure, and updates the schedule to avoid the risk when it is needed. By using the simulation model, the users can experiment various scenarios in operations quickly, and also can make a decision not based on their past experience or intuition but based on scientific estimation of risks even in urgent situations. An example of such an operational decision making process is demonstrated for a real mid-size emergency medical center located in Seoul, Republic of Korea. The model is designed for temporal short-term planning especially, but it can be expanded for long-term planning also with some appropriate adjustments.

The maxillofacial region is susceptible to damage because facial bone is prominent. The aim of this study is to evaluate the incidence, etiology, seasonal distribution, and patterns of maxillofacial injuries and investigate the percentage of bone fractures on CT scans by patient’s gender and age. Electronic medical records of 1,483 patients who had maxillofacial injuries and visited the Emergency Medical Center of Chonnam National Hospital were evaluated. Age, gender, etiology, seasonal occurrence, frequency of fracture, and the pattern of bone fracture were analyzed by using IBM SPSS Statistics 21 (SPSS Inc., Chicago, IL, USA). Male to female ratio was 2.82:1. The most common causes of injury were falls or collisions (male 40.09%, female 48.2%), followed by traffic accidents and violence. The number of injuries related to sporting accidents, assult, and industrial accidents was higher in male patients than that of female patients. With regard to the seasonal occurrence, 434 cases (29.26%) occurred in the summer, while 306 cases (20.63%) occurred in the winter. In this study, 946 patients (63.79%) were identified to have facture and 537 patients (36.21%) were found to be without fracture on CT scans. The orbital bone (41.38%) was the most commonly fractured in the mid facial structures. The most common fracture site in the mandible was the body of the mandible (23.13%). The patterns of maxillofacial injuries were various based on gender, age, cause of injury, and season.

This study is performed to determine the priorites of the evaluation factors for the improvement of fire emergency medical service by increasing it’s efficiency to protect the people’s lives effectively, and by recognizing it’s mid-long term development. Based on the output of the analysis, the critical evaluation factors of the fire emergency medical services to be improved shall be identified, and shall be intended to use strategically for increasing the efficiency of all the activity in the EMT service, and also for providing the basic date to product and manage the good quality services. To calculate the priority of the evaluation factor for each level as shown on this study, AHP(anaysis hierarchy process) with pairwise comparison method is applied. According to the priority analysis for the evaluation factors in main category (evaluation zone), ‘medical service professional aspect’ is recognized as highest one, and ‘service infrastructure aspect, ‘service management aspect’ are indicated in order. According to the priority analysis for the evaluation factors in evaluation index, ‘professional personal arrangement’ in the service infrastructure aspect, ‘appropriateness and timeliness of emergency medical care’ in the medical service professional aspect, and ‘clinical training’ in the service management aspect are respectively recognized as most important factors.

산업화의 발달과 각종 사고의 증가, 심질환 등 응급의료와 관련있는 질환의 사망률 등이 높아짐에 따라 국가 응급의료서비스의 필요성과 중요성이 더욱 더 부각되어 이 에 대한 문헌연구와 질과 관련된 선행연구에서 논의된 핵심요인들을 국내병원 전단계 인 소방응급의료서비스에 대한 서비스 강화를 위한 평가요인으로 도출, 이를 AHP기법 을 활용하여 평가요인들에 대한 중요도 및 우선순위를 분석하여 분석결과를 기반으로 소방응급의료서비스에서 중점을 두어야 하는 요인과 요인에 대한 우선순위를 제시함 으로써 소방응급의료서비스의 질적 향상을 도모하고자 한다.

The purpose of this study was to identify vulnerable area of emergency medical care. In the existing method, the emergency medical vulnerable area is set as an area that can not reach the emergency room within 30 minutes. In this study, we set up an area that can not reach within 30 minutes including the accessibility of 119 emergency center. To accomplish this, we obtained information on emergency room and 119 emergency center through Open API and constructed road network using digital map to perform accessibility analysis. As a result, 509 emergency room are located nationwide, 78.0% of them are concentrated in the region, 1,820 emergency center are located, and 61.0% of them are located in rural areas. The average access time from the center of the village to the emergency room was analyzed as 15.3 minutes, and the average access time considering the 119 emergency center was 21.8 minutes, 6.5 minutes more. As a result of considering the accessibility of 119 emergency center, vulnerable areas increased by 2.5 times, vulnerable population increased by 2.0 times, and calculating emergency medical care vulnerable areas, which account for more than 30% of the urban unit population, it was analyzed that it increased from 17 to 34 cities As a further study, it will be necessary to continuously monitor and research the real-time traffic information, medical personnel, medical field, and ambulance information to reflect the reality and to diagnose emergency medical care in the future.

응급의료는 부정적 영향요인을 다량 내포하고 있음에도 불구하고 발전을 거듭해오고 있다. 보건복지부나 대한응급의학회에서는 이러한 부정적 영향요인의 해소를 위해 응급 실 과밀화와 비응급환자의 조절을 위한 한국형 중증도 분류체계와 같은 정책을 지속적 으로 시행하고 있다. 그러나 이러한 현장 속에서 일하는 의료진의 응급의료에 대한 정체 성은 공적으로 거론되지 않는 분위기였다. 이는 전문직으로써 소명감을 중요시하는 문 화와 공공연한 사실을 공론화하는 것에 지나지 않는다는 국내 의료계의 풍토가 큰 몫을 차지하는 것으로 생각된다. 하지만 의료진의 업무에 대한 정체성은 전문 직관과 연결되 어, 소진, 이직으로 이어지므로 매우 중요하다. 이러한 정체성의 규명은 당면한 현실을 재인식하게 하고, 그 속의 자아를 재구성하는데 중요한 역할을 한다. 따라서 본 연구에 서는 응급실 의료진 10인을 대상으로 생생한 응급의료의 정체성에 대한 담론을 듣고자 내러티브를 시행하였다. 본 연구 결과, 응급의료진들은 시대가 요구하는 응급의료의 왜 곡, 수혜자와 제공자간의 딜레마, 국가 차원의 총합적 단계의 조정력 부족과 같은 부정 적 문제 개선을 중심 정체성으로 인식하고 있었다. 이를 통해 의료진의 부권주의적 성향 을 알 수 있었다. 이러한 결과는 의료진들이 응급의료에 대해 긍정적인 개선의지가 뚜렷 하다는 것으로 파악되며 추후 여러 병원의 다각적인 연구를 제언하는 바이다.

The aim of this study is to confirm the importance of a more immediate advanced cardiac life support (ACLS) through a comparative analysis of the results of cardiopulmonary resuscitation (CPR) according to the occurrence place of cardiac arrest in tertiary emergency department. The subjects were 493 patients who had received CPR in Chosun university, Emergency Medical Department, between April 2013 and March 2015. The subjects were categorized into three groups according to the occurrence place of cardiac arrest: pre-hospital, in-emergency room, and in-ward. We conducted a clinical analysis of the results. During the period, 493 cardiac arrest patients underwent CPR, 63 patients (12.8%) were discharged alive and 41 patients (8.3%) got a good score on the cerebral performance category (CPC). Concerned occurrence place of cardiac arrest, 11.3% (16 patients) of the in-emergency room group (total 288 patients) were discharged alive. Also, 9.4% (27 patients) of the In-emergency room group got a good score on the CPC. In the other two-group cases, 7.1% (10 patients) of pre-hospital group (total 141 patients) and 6,2% (4 patients) of in-ward group (total 64 patients) got a good score on the CPC. These results indicate that both the rates of alive discharge and a good CPC score of the in-emergency room group are higher than in out-of-emergency room. This difference might be due to the fact that patients could get the more immediate ACLS by emergency medicine doctors if cardiac arrest occurs in emergency room than other places.