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

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.