The impact of a medical residents' walkout on mortality rates in South Korea, 2024

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Health Policy Pub Date : 2025-06-10 DOI:10.1016/j.healthpol.2025.105375

Jin-Hwan Kim , Saerom Kim

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引用次数: 0

Abstract

Background

At the end of February 2024, over 11,000 medical residents in South Korea collectively resigned in opposition to the government's policy to increase medical school admissions, raising widespread concerns about potential health consequences amid prolonged workforce shortages in acute hospitals.

Objective

To assess the impact of the medical residents' walkout on mortality rates in South Korea during 2024.

Methods

We conducted a retrospective observational study using mortality data from Statistics Korea's Vital Statistics (2019–2023) and the Ministry of Interior and Safety's Registration Expiration Statistics (2024). Analyses included crude mortality rates by sex, age, and region; sex- and age-standardized mortality rates; and excess mortality estimations using three modeling approaches with and without COVID-19 fixed effects.

Results

We found no evidence of increased mortality in 2024. During the walkout period (March-December 2024), mortality rates (577.4 per 100,000) and age-standardized mortality rates (approximately 650 and 750 per 100,000 for females and males) showed no increase from pre-walkout levels. Excess mortality estimates were consistently negative or negligibly small (-11,989 to -2831 deaths, 95 % CI) after controlling for COVID-19 effects, with more pronounced negative values during the walkout period (-30,779 to -7767). This pattern persisted across demographic groups and regions.

Conclusions

During a year-long walkout, mortality patterns in South Korea remained stable, consistent with findings from shorter healthcare strikes. Policymakers should establish robust and democratic dialogue for healthcare reforms, while researchers should investigate non-mortality impacts, including healthcare quality, access, and patient experiences, to develop comprehensive workforce policies.

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2024年韩国医疗住院医师罢工对死亡率的影响

2024年2月底，韩国1.1万多名医疗住院医师集体辞职，以反对政府增加医学院招生的政策，这引发了人们对急性医院长期劳动力短缺的潜在健康后果的广泛担忧。目的评估2024年韩国医疗住院医师罢工对死亡率的影响。方法利用统计厅生命统计（2019-2023年）和行政安全部登记过期统计（2024年）的死亡率数据进行回顾性观察研究。分析包括按性别、年龄和地区划分的粗死亡率；性别和年龄标准化死亡率；以及使用具有和不具有COVID-19固定效应的三种建模方法进行的超额死亡率估计。结果我们没有发现2024年死亡率增加的证据。在罢工期间（2024年3月至12月），死亡率（每10万人577.4人）和年龄标准化死亡率（女性和男性分别约为每10万人650人和750人）与罢工前相比没有增加。在控制COVID-19效应后，超额死亡率估估始终为负值或可忽略不计的小（- 11989至-2831例死亡，95% CI），在罢工期间（-30,779至-7767）出现更明显的负值。这种模式在各个人口群体和地区都持续存在。在为期一年的罢工期间，韩国的死亡率模式保持稳定，与较短的医疗保健罢工的结果一致。决策者应该为医疗改革建立强有力的民主对话，而研究人员应该调查非死亡率影响，包括医疗质量、获取和患者体验，以制定全面的劳动力政策。

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

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.