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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BMC
2025-03-01
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| 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. |
| format | Article |
| id | doaj-art-ff17f122ac0d49fab80f2e2d360683dc |
| institution | DOAJ |
| issn | 1471-227X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| 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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