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

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Arum Choi, Beom Joon Kim, Jooyoung Lee, Sukil Kim, Woori Bae
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引用次数: 0

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.

韩国政府宣布扩充医学院对儿科急诊科就诊的影响。
背景:2024年2月,韩国政府宣布医学院招生人数增加67%(增加2000名学生),导致大约1万名住院医生从主要大学医院辞职。本研究调查了这些辞职对韩国一家主要三级医院儿科急诊科(PED)访问量的影响。方法:对2019年1月至2024年5月12日在某三级医院就诊的15岁以下PED患者进行回顾性观察研究。在排除了缺少诊断代码或处置记录的病例后,我们分析了不同年份(2019-2024年)2月19日至5月12日12周内的就诊情况。我们使用中断时间序列(ITS)分析的分段回归来评估三个关键事件的影响:COVID-19的发病,解除口罩要求和居民辞职,并调整季节变化和自相关性。结果:在分析的11574例患者中,与新冠肺炎前(246.3±45.2)和后(263.7±61.2)期相比,居民辞职后每周PED就诊次数(133.6±22.4)次显著减少。辞职期间,KTAS 3型患者的比例比新冠疫情前(48.9%)增加了67.2%。ITS分析显示,每周就诊次数立即发生了显著变化:COVID-19(-157.81次,95% CI: -202.04至-113.58),口罩强制拆除(48.26次,95% CI: 3.21至93.32),以及居民辞职(-77.82次,95% CI: -134.85至-20.80)。值得注意的是,传染病的比例上升(36.9%,前疫情为18.6%),呼吸系统疾病的比例下降(20.1%,前疫情为33.6%)。结论:在我们儿科急诊科的全国居民罢工开始后,观察到绝对和相对每周患者访问量的大幅减少。需要进一步的研究来更好地了解这如何影响儿科急诊护理的提供和获取。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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