Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits

Abstract Background In February 2024, the South Korean government announced a 67% increase in medical school admissions (2,000 more students), leading to the resignation of approximately 10,000 residents from major university hospitals. This study investigated the impact of these resignations on ped...

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Main Authors: Arum Choi, Beom Joon Kim, Jooyoung Lee, Sukil Kim, Woori Bae
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Emergency Medicine
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Online Access:https://doi.org/10.1186/s12873-025-01189-w
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author Arum Choi
Beom Joon Kim
Jooyoung Lee
Sukil Kim
Woori Bae
author_facet Arum Choi
Beom Joon Kim
Jooyoung Lee
Sukil Kim
Woori Bae
author_sort Arum Choi
collection DOAJ
description Abstract Background In February 2024, the South Korean government announced a 67% increase in medical school admissions (2,000 more students), leading to the resignation of approximately 10,000 residents from major university hospitals. This study investigated the impact of these resignations on pediatric emergency department (PED) visits at a major tertiary hospital in Korea. Methods We conducted a retrospective observational study analyzing PED visits under 15 years old at a tertiary hospital from January 2019 to May 12, 2024. After excluding cases with missing diagnostic codes or disposition records, we analyzed visits during the 12-week period from February 19 to May 12 across different years (2019–2024). We used segmented regression of Interrupted Time Series (ITS) analysis to evaluate the impact of three key events: the COVID-19 onset, lifting of mask-wearing mandates, and residents’ resignation, adjusting for seasonal variations and autocorrelation. Results Among 11,574 analyzed cases, weekly PED visits decreased significantly after residents’ resignation (133.6 ± 22.4) compared to pre-COVID-19 (246.3 ± 45.2) and post-COVID-19 (263.7 ± 61.2) periods. The proportion of KTAS 3 cases increased to 67.2% during the resignation period compared to pre-COVID-19 (48.9%). ITS analysis revealed significant immediate changes in weekly visits: COVID-19 (-157.81 visits, 95% CI: -202.04 to -113.58), mask mandate removal (48.26 visits, 95% CI: 3.21 to 93.32), and residents’ resignation (-77.82 visits, 95% CI: -134.85 to -20.80). Notably, the proportion of infectious diseases increased (36.9% vs. 18.6% pre-COVID-19), while respiratory diseases decreased (20.1% vs. 33.6% pre-COVID-19). Conclusion A substantial reduction in both absolute and relative weekly patient visits was observed following the start of the nationwide resident strike at our pediatric emergency department. Additional studies are needed to better understand how this affected pediatric emergency care delivery and access.
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spelling doaj-art-ff17f122ac0d49fab80f2e2d360683dc2025-08-20T03:04:22ZengBMCBMC Emergency Medicine1471-227X2025-03-012511810.1186/s12873-025-01189-wImpact of the South Korean government’s medical school expansion announcement on pediatric emergency department visitsArum Choi0Beom Joon Kim1Jooyoung Lee2Sukil Kim3Woori Bae4Department of Radiology, College of Medicine, The Catholic University of KoreaDepartment of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Preventive Medicine and Public Health, College of Medicine, The Catholic University of KoreaDepartment of Emergency Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract Background In February 2024, the South Korean government announced a 67% increase in medical school admissions (2,000 more students), leading to the resignation of approximately 10,000 residents from major university hospitals. This study investigated the impact of these resignations on pediatric emergency department (PED) visits at a major tertiary hospital in Korea. Methods We conducted a retrospective observational study analyzing PED visits under 15 years old at a tertiary hospital from January 2019 to May 12, 2024. After excluding cases with missing diagnostic codes or disposition records, we analyzed visits during the 12-week period from February 19 to May 12 across different years (2019–2024). We used segmented regression of Interrupted Time Series (ITS) analysis to evaluate the impact of three key events: the COVID-19 onset, lifting of mask-wearing mandates, and residents’ resignation, adjusting for seasonal variations and autocorrelation. Results Among 11,574 analyzed cases, weekly PED visits decreased significantly after residents’ resignation (133.6 ± 22.4) compared to pre-COVID-19 (246.3 ± 45.2) and post-COVID-19 (263.7 ± 61.2) periods. The proportion of KTAS 3 cases increased to 67.2% during the resignation period compared to pre-COVID-19 (48.9%). ITS analysis revealed significant immediate changes in weekly visits: COVID-19 (-157.81 visits, 95% CI: -202.04 to -113.58), mask mandate removal (48.26 visits, 95% CI: 3.21 to 93.32), and residents’ resignation (-77.82 visits, 95% CI: -134.85 to -20.80). Notably, the proportion of infectious diseases increased (36.9% vs. 18.6% pre-COVID-19), while respiratory diseases decreased (20.1% vs. 33.6% pre-COVID-19). Conclusion A substantial reduction in both absolute and relative weekly patient visits was observed following the start of the nationwide resident strike at our pediatric emergency department. Additional studies are needed to better understand how this affected pediatric emergency care delivery and access.https://doi.org/10.1186/s12873-025-01189-wEmergency Department visitsHealthcare policyPediatric emergency departmentResidents resignationStrikes
spellingShingle Arum Choi
Beom Joon Kim
Jooyoung Lee
Sukil Kim
Woori Bae
Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
BMC Emergency Medicine
Emergency Department visits
Healthcare policy
Pediatric emergency department
Residents resignation
Strikes
title Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
title_full Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
title_fullStr Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
title_full_unstemmed Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
title_short Impact of the South Korean government’s medical school expansion announcement on pediatric emergency department visits
title_sort impact of the south korean government s medical school expansion announcement on pediatric emergency department visits
topic Emergency Department visits
Healthcare policy
Pediatric emergency department
Residents resignation
Strikes
url https://doi.org/10.1186/s12873-025-01189-w
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