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진료권별 응급의료자원 실태조사 및 한 종합병원에서의 응급의료이용 현황

Other Titles
 (A) study on research of emergency medical resources within medical service areas and the present condition of using emergency care at general hospital 
Issue Date
1991
Description
병원행정학과/석사
Abstract
[한글] 날로 증가하는 응급의료수요에 대응하여 양질의 응급의료서비스를 받을 수 있는 체계를 구축하고자 하는 것이 주요 의료정책과제로 부각되고 있다. 이 연구는 응급센타 또는 응급지정병원으로 신청한 의료기관들의 시설 · 장비 · 인력 현황등을 보사부 기준과 비교 하여 적합한지를 진료권별로 분석하였고, 1991. 3. 22부터 3. 29일까지 8일간 한 종합병원 응급실을 이용한 환자들의 내원이유, 후송수단, 응급실에서의 처치등을 조사하여 응급 의료현실의 문제점을 분석하고자 하였으며 그 주요 결과는 다음과 같다. 1. 진료권별로 신청한 병원의 응급의료자원을 응급센타 또는 응급의료지정병원 지정기준에 의거 7개항목으로 구분하여 대비한 결과, 지정기준조건을 모두 갖추고 있는 병원이 센타의 경우는 전무하고, 지정병원의 경우는 3개소 뿐이었다. 2. 응급의료자원중 중요하다고 생각되는 3개항목(병원규모, 응급실의료인력, 응급실시설)을 지정기준조건에 대비한 결과 신청병원중 54.9%(107개소)가 위 조건에 적합하였다. 이는 보사부에서 확보하려고 하는 센타 대상 병원수 128개의 83.6%를 나타낸 반면, 센타 최소 병원수 79개보다는 많은 병원이 확보된 비율(135.5%)로 나타났다. 3. 한 종합병원의 응급의료이용 실태의 분석결과 응급실 이용판자는 주로 20-60세 인구군으로 사회적 · 경제적 연령층의 활동인구가 다수를 차지하고 있었고, 60세 이상의 인구층에서도 응급환자 발생이 높은 것으로 나타났으며 주로 진료시간 이외의 야간시간대에 많이 내원하고 있음을 알 수 있었다. 4. 응급환자의 내원수단은 병원구급차를 이웅하는 비율이 저조하고, 자가수단에 의해 응급실로 후송하고 있었고 내원등기는 주로 급성질환등 실질적으로 응급을 요하는 상태가 높은 비율로 나타난 반면, 내원환자중 상당수가 응급환자로 보기 어려운 귀가자(귀가율 42.7%)였다. 5. 병원전단계 또는 후송단계의 응급처치는 전무한 상태로 환자발생현장에서의 응급처치에 문제점이 도출되었고 병원단계의 응급치료에 있어서도 초기에 전문의 치료가 거의 없이 인턴등 전공의들이 내원환자의 86.2%나 초진에 임하고 있었다. 6. 응급환자 또는 보호자등의 이용시 느낀 문제점을 살펴보면 응급실시설에 대한 정보를 모르는 상황에서 병원선택등 환자후송을 자기판단에 의거 임의적으로 처리하고 있어 적당한 병원으로 응급후송이 가능할 수 있도록 정보를 제공해주는 응급의료정보체계의 확립이 시급히 요청된다. A Study on Research of Emergency Medical Resources within Medical Service Areas and the Present Condition of Using Emergency Care at General Hospital HAK Kl CHung Graduate School of Health science and Management, Yonsei University (Directed by professor Han Joong trim, M.D, Ph.D) It is emerging as the major theme of medical policy to establish the system which can provide good emergency services, responding to the daily increasing demand on emergency services. This study analized the appropriateness of the present condition of facilities, equipments and personnel in medical organizations which had applied for being certified as emergency centers or appointed emergency hospitals, in comparison with the standard of the Ministry of health and social of fairs(MOHSA),and attempted to analize the problems of the present emergency services by researching into the visiting reasons, transportation means, treatment in the emergency department for the patients who had used the emergency department of a general hospital for 8 days from 22, March,1991 to 29, March. The major results are as follows: 1. In the consequence of comparing the emergency medical resources in hospitals within medical service areas which applied for with the standards of emergency center or appointed emergency hospital which had been classified into 7 items, no emergency center and only three appointed emergency hospitals which met the standards were identified within those which had applied for. 2. In the results of being compared with the three items of standards for emergency medical resources which were regarded as important (i.e. the size of hospitals, the personnel and facilities of emergency department), 54,9%(107 applicants) o those which had applied for, were appropriate for the above standards. This number falls on 83.6% of the 128 emergency centers, the MOHSA is attempting to secure, but is larger than the minimum 79 centers (135.5%). 3. In the results of analizing the persent condition of using emergency care at a general hospital, most patients who had used the emergency department were in the age of 20-60, being the socially and economically active age group, and many emergency patients were also in the age of above sixity. They were identified as to visit chiefly in the night time zone, out of the service hours. 4. As for the visiting means, the percentage of using the ambulance was low and the patients were chiefly transported to the emergency department via private means. As for the visiting motive, the percentage of the acute and chronic deseases which substantially require emergency treatment was high, but many of those who had visited were returned home as being difficult to consider as emergency patients (returning ratio, 42.7 %). 5. Problems on emergency treatment at the site of patients occurrence were induced, there being no prehospital or transportation care. Moreover, as for hospital care, there were almost no treatment by a medical specialist at the early phase, and as large as 86.2% of visiters were treated at the early phase by those who were in the cource of specialization such as interns. 6. Surveying the problems felt by the emergency patients or their patrons, where there was no knowing the information on using the emergency department, they were disposing the selection of hospitals, patient transportation, etc. according to their own judgement, and so urgent is the establishment of emergency care information system which provides information so as to make it possible to transport patients to appropriate hospitals.
[영문] It is emerging as the major theme of medical policy to establish the system which can provide good emergency services, responding to the daily increasing demand on emergency services. This study analized the appropriateness of the present condition of facilities, equipments and personnel in medical organizations which had applied for being certified as emergency centers or appointed emergency hospitals, in comparison with the standard of the Ministry of health and social of fairs(MOHSA),and attempted to analize the problems of the present emergency services by researching into the visiting reasons, transportation means, treatment in the emergency department for the patients who had used the emergency department of a general hospital for 8 days from 22, March,1991 to 29, March. The major results are as follows: 1. In the consequence of comparing the emergency medical resources in hospitals within medical service areas which applied for with the standards of emergency center or appointed emergency hospital which had been classified into 7 items, no emergency center and only three appointed emergency hospitals which met the standards were identified within those which had applied for. 2. In the results of being compared with the three items of standards for emergency medical resources which were regarded as important (i.e. the size of hospitals, the personnel and facilities of emergency department), 54,9%(107 applicants) o those which had applied for, were appropriate for the above standards. This number falls on 83.6% of the 128 emergency centers, the MOHSA is attempting to secure, but is larger than the minimum 79 centers (135.5%). 3. In the results of analizing the persent condition of using emergency care at a general hospital, most patients who had used the emergency department were in the age of 20-60, being the socially and economically active age group, and many emergency patients were also in the age of above sixity. They were identified as to visit chiefly in the night time zone, out of the service hours. 4. As for the visiting means, the percentage of using the ambulance was low and the patients were chiefly transported to the emergency department via private means. As for the visiting motive, the percentage of the acute and chronic deseases which substantially require emergency treatment was high, but many of those who had visited were returned home as being difficult to consider as emergency patients (returning ratio, 42.7 %). 5. Problems on emergency treatment at the site of patients occurrence were induced, there being no prehospital or transportation care. Moreover, as for hospital care, there were almost no treatment by a medical specialist at the early phase, and as large as 86.2% of visiters were treated at the early phase by those who were in the cource of specialization such as interns. 6. Surveying the problems felt by the emergency patients or their patrons, where there was no knowing the information on using the emergency department, they were disposing the selection of hospitals, patient transportation, etc. according to their own judgement, and so urgent is the establishment of emergency care information system which provides information so as to make it possible to transport patients to appropriate hospitals.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/117014
Appears in Collections:
2. 학위논문 > 4. Graduate School of Public Health (보건대학원) > 석사
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