Work

Changes in the nationwide number of emergency department visits following the junior physicians’ walkout in South Korea: An interrupted time-series analysis

Year: 2025

Type: article

Abstract: OBJECTIVES: A walkout of junior physicians in South Korea began on February 20, 2024, in response to the government's plan to expand medical school enrollment. Given that junior doctors are the first to assess and manage patients in emergency department (ED) in Korea, their absence may disrupt emergency medical services. This study aimed to evaluate nationwide changes in ED utilization following the walkout. STUDY DESIGN: Descriptive time series study. METHODS: Nationwide ED visit data were extracted from the National Health Insurance Database between June 1, 2022, and November 30, 2024. An interrupted time series analysis adjusting for seasonality was used to evaluate changes in disease specific ED visits after the walkout. Additionally, trends in the total number of ED beds and their occupancy rates were analyzed. RESULTS: ED visits sharply declined in the week of the walkout. The estimated step-change was -24,871 visits (95 % CI: -32,542, -17,201) for all-cause and -19,211 visits (95 % CI: -24,922, -13,500) for non-accidental diseases. The greatest step change decreases observed were respiratory diseases, external injuries, infectious diseases, and digestive diseases. The occupancy rate of nationwide general ED beds and pediatric beds sharply declined after walkout and did not return to pre-strike levels, even during the resurgence of COVID-19. CONCLUSIONS: The junior physicians' walkout was associated with a substantial reduction in ED visits and ED capacity. These findings may reflect both a scale-down of emergency medical services and changes in healthcare-seeking behavior. Further research is needed to assess the public health implications of such abrupt service disruptions.

Source: Public Health

DOI: 10.1016/j.puhe.2025.105984

Author: Changwoo Han

Institutions: Scripps Institution of Oceanography, Chungnam National University, University of California San Diego

Language: English

Topic: Emergency and Acute Care Studies

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,130