Journal of Yeungnam Medical Science

Original articles

Emergency and Critical Care Medicine
Comparing emergency medical system governance in Japan and South Korea: lessons for high-income countries from a multisource comparative health systems analysis: Kentaro Kajino, Jung Ho Kim, Jeong Ho Park, Kyoung-Jun Song, Mohamud R. Daya, Yasuyuki Kuwagata; J Yeungnam Med Sci. 2026;43:3. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.3

559 View
42 Download

Abstract PDF Supplementary Material: Background
Japan and South Korea, two advanced East Asian nations with universal health coverage and similar demographic challenges, have developed markedly different emergency medical services (EMS) systems. Despite growing interest in international benchmarking, structured, comparative studies that yield policy-relevant insights remain limited.
Methods
We conducted a multisource comparative health-systems analysis using statutory laws, government publications, academic society reports, peer-reviewed literature, and national statistics. Key domains included EMS governance, workforce, prehospital organization, hospital-based emergency care, legal obligations for EMS patient transport and hospital acceptance, and governance and quality assurance mechanisms. Data were synthesized in comparative tables and narrative summaries to highlight structural and operational differences.
Results
Japan’s EMS system operates under decentralized municipal control through 722 fire departments, serving 4,100 designated emergency institutions with 6,139 board-certified emergency physicians. In 2023, over 6.64 million ambulance dispatches occurred, and 8.6% were classified as critical cases (1.3% death and 7.3% severe). Korea’s EMS system is centrally governed with 412 designated facilities in a tiered system and 2,464 specialists. Annual ambulance activations exceeded 3.5 million, with severe cases accounting for approximately 5% to 10%. Japan employs a multilayered legal–institutional structure, primarily involving the Fire Service Act and the Medical Practitioners Act, allowing clinical discretion, whereas Korea enforces unified regulations with stricter obligations and criminal penalties for hospital refusal of emergency patients.
Conclusion
The contrasting systems suggest that hybrid governance that combines centralized standard settings with local operational flexibility may optimize EMS performance. These findings provide lessons for EMS reform, cross-border collaboration, and disaster preparedness in high-income nations facing similar demographic and healthcare challenges.

Emergency and Critical Care Medicine
Effect of reducing urban road speed limits on motorcyclist traffic accidents: a before-and-after study using the National Emergency Department Information System of South Korea: Seunghyun Baek, Jung Ho Kim; J Yeungnam Med Sci. 2025;42:51. Published online September 1, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.51

969 View
42 Download

Abstract PDF: Background
Motorcycles are widely used in various transportation sectors, but riders are directly exposed to external risks. Consequently, motorcyclists are more vulnerable to severe injuries. Road speed limits serve as key policy interventions to mitigate this risk. This study aims to evaluate the effects of reducing urban road speed limits on motorcyclist traffic accidents.
Methods
In this study, National Emergency Department Information System data from the seven largest cities in South Korea were analyzed by comparing a pre-implementation (April 17, 2018 to April 16, 2019) and post-implementation (April 17, 2021 to April 16, 2022) phase. The Pearson chi-square test was used. Additionally, univariable and multivariable logistic regression analyses were performed to assess the effects of the policy on emergency operations, intensive care unit (ICU) admission, and clinical outcomes. Statistical significance was set at p<0.05.
Results
The number of patients decreased from 16,124 to 13,201, along with a reduction in emergency surgeries (n=61) and ICU admissions (n=184); however, unfavorable outcomes increased (n=9). The risk of emergency surgery (adjusted odds ratio [aOR], 1.093; 95% confidence interval [CI], 0.935–1.277) was not statistically significant. However, the risk of ICU admission (aOR, 1.147; 95% CI, 1.015–1.296) and unfavorable outcomes (aOR, 1.502; 95% CI, 1.052–2.145) increased significantly in the post-implementation period.
Conclusion
Although the number of patients significantly decreased, there was no corresponding improvement in clinical outcomes. Instead of abolishing the policy, revising it would be a more appropriate approach. Therefore, additional public interventions and educational programs are required.

Emergency and Critical Care Medicine
Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study: Yo Han Cho, Jae Wan Cho, Hyun Wook Ryoo, Sungbae Moon, Jung Ho Kim, Sang-Hun Lee, Tae Chang Jang, Dong Eun Lee; J Yeungnam Med Sci. 2022;39(1):31-38. Published online August 10, 2021; DOI: https://doi.org/10.12701/yujm.2021.01130

8,916 View
129 Download
9 Web of Science
11 Crossref

Abstract PDF

Background
To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, Korea.
Methods
We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis.
Results
During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between study periods; however, the results showed statistically significant differences in the length of ED stay.
Conclusion
The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Citations

Citations to this article as recorded by

Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
Arum Choi, Beom Joon Kim, Jooyoung Lee, Sukil Kim, Woori Bae
BMC Emergency Medicine.2025;[Epub] CrossRef
Impact of Medical Residency Programs on Emergency Department Efficiency
Myeong Namgung, Sung Jin Bae, Ho Sub Chung, Kwang Yul Jung, Yun Hyung Choi, Chan Woong Kim, Ye Lim Gong, Ji Yun Lee, Dong-Hoon Lee
Medicina.2025; 61(6): 999. CrossRef
A deliberative framework to assess the justifiability of strike action in healthcare
Ryan Essex
Nursing Ethics.2024; 31(2-3): 148. CrossRef
Impact of junior doctor strikes on patient flow in the emergency department: a cross-sectional analysis
Svenja Ravioli, Raeesa Jina, Omar Risk, Fleur Cantle
European Journal of Emergency Medicine.2024; 31(1): 53. CrossRef
What Do Trainees Want? The Rise of House Staff Unions
Debra Malina, Lisa Rosenbaum
New England Journal of Medicine.2024; 390(3): 279. CrossRef
Medical students’ professionalism attributes, knowledge, practices, and attitudes toward COVID-19 and attitudes toward care provision during pandemic amidst the COVID-19 outbreak according to their demographics and mental health
Eun Kyung Choi, Sanghee Yeo
Korean Journal of Medical Education.2024; 36(2): 157. CrossRef
Impacts of industrial actions, protests, strikes and lockouts by health and care workers during COVID-19 and other pandemic contexts: a systematic review
Isabel Craveiro, Pradeep Kumar Choudhury, Ana Paula Cavalcante de OLiveira, Alessandra Pereira, Inês Fronteira, Raphael Chança, Giorgio Cometto, Mario Roberto Dal Poz, Paulo Ferrinho
Human Resources for Health.2024;[Epub] CrossRef
Why Did All the Residents Resign? Key Takeaways From the Junior Physicians’ Mass Walkout in South Korea
Jinwook Park, Chang Ho Shin, Joo-Young Lee
Journal of Graduate Medical Education.2024; 16(4): 402. CrossRef
Comparison of the postoperative complications for gastric cancer surgery before and during the medical crisis in South Korea: a retrospective observational study
Kyoungdong Lee, Ba Ool Seong, Moon-Won Yoo
Annals of Surgical Treatment and Research.2024; 107(6): 354. CrossRef
Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim
Journal of Yeungnam Medical Science.2023; 40(2): 179. CrossRef
Study on the Learning Environment of Medical Students in the COVID-19
Yu Ra Kim, Hye Jin Park, Saeyoon Kim
Keimyung Medical Journal.2023; 42(2): 80. CrossRef

Emergency and Critical Care Medicine
Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city: Jung Ho Kim, Hyun Wook Ryoo, Sungbae Moon, Tae Chang Jang, Sang Chan Jin, You Ho Mun, Byung Soo Do, Sam Beom Lee, Jong-yeon Kim; Yeungnam Univ J Med. 2019;36(3):241-248. Published online July 2, 2019; DOI: https://doi.org/10.12701/yujm.2019.00248

9,304 View
84 Download
1 Crossref

Abstract PDF

Background
Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS).
Methods
We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression.
Results
Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102–3.017). The most suitable cutoff point for MHI by Youden’s index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%).
Conclusion
Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.

Citations

Citations to this article as recorded by

Ambient heat exposure and kidney function in patients with chronic kidney disease: a post-hoc analysis of the DAPA-CKD trial
Zhiyan Zhang, Hiddo J L Heerspink, Glenn M Chertow, Ricardo Correa-Rotter, Antonio Gasparrini, Niels Jongs, Anna Maria Langkilde, John J V McMurray, Malcolm N Mistry, Peter Rossing, Robert D Toto, Priya Vart, Dorothea Nitsch, David C Wheeler, Ben Caplin
The Lancet Planetary Health.2024; 8(4): e225. CrossRef

Case report

Cardiology and Cardiovascular Medicine
Late complication of the Nuss procedure: recurrent cardiac tamponade: Won Jong Park, Jang Won Son, Kyu Hwan Park, You Min Kim, Jong Ho Nam, Kang Un Choi, Jung Ho Kim; Yeungnam Univ J Med. 2019;36(3):260-264. Published online June 13, 2019; DOI: https://doi.org/10.12701/yujm.2019.00241

8,991 View
71 Download
1 Crossref

Abstract PDF

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Citations

Citations to this article as recorded by

A case of atrial fibrillation in a 14-year-old boy having Nuss bars for 3 years
Brian Lefchak, Ian Thomas
Pediatric Emergency Medicine Journal.2025; 12(4): 164. CrossRef

Case Reports

Emergency and Critical Care Medicine
Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule: You Ho Moon, Jung ho Kim, Won joon Jeong, Sin-Youl Park; Yeungnam Univ J Med. 2018;35(1):127-129. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.127

8,768 View
70 Download
1 Crossref

Abstract PDF

Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

Citations

Citations to this article as recorded by

Analysis of Misdiagnosis of FHCS Syndrome as Cholecystitis and Literature Review
旭旗申
Advances in Clinical Medicine.2022; 12(06): 5608. CrossRef

Emergency and Critical Care Medicine
A Case of Subcutaneous Emphysema without Associated Injuries at Neck from Motorcycle Accident.: Jung Ho Kim, Sam Beom Lee, Byung Soo Do; Yeungnam Univ J Med. 2003;20(2):217-222. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.217

2,298 View
8 Download

Abstract PDF: Subcutaneous emphysema defines collection of air in subcutaneous spaces of body. It is usually originated from air in upper airway and lower respiratory tract such as larynx, trachea, bronchus and lungs. Air in subcutaneous spaces derives from leakage of air due to tearing or ruptures of airway structures, and also accompanies pneumothorax or pneumomediastinum and/or rib or sternal fractures or other major airway injuries. We experienced a case of subcutaneous emphysema caused by laryngeal injury without any associated airway injuries at neck from motorcycle accident, so we would report a case with the review of literatures.

Emergency and Critical Care Medicine
A Case of Spontaneous Pneumomediastinum without Direct Cause.: Sam Beom Lee, Jung Ho Kim, Byung Soo Do; Yeungnam Univ J Med. 2003;20(2):212-216. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.212

2,091 View
0 Download

Abstract PDF: No abstract available.

Original Article

Emergency and Critical Care Medicine
Multimarker Approach by Troponin T, C-Reactive Protein, and CK-MB to Assessment in AMI in the Emergency Department.: Sam Beom Lee, Jung Ho Kim, Byung Soo Do; Yeungnam Univ J Med. 2003;20(2):197-205. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.197

2,262 View
2 Download

Abstract PDF: No abstract available.

Case Report

Pediatrics, Perinatology, and Child Health
Congenital Left Ventricular Diverticulum.: Jong Young Kim, Jung Ho Kim, Jin Gon Jun; Yeungnam Univ J Med. 1990;7(2):181-187. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.181

2,214 View
3 Download

Abstract PDF: Congenital diverticulosis of the left ventricle is an extremely are rare maldevelopment. We report a 9 year old girl with probable isolated left ventricular diverticulum in whom the diagnosis was made by cross sectional echocardiography and by angiography.

First
Prev
Page of 1
Next
Last

Search