Analysis of the Impact of the Coronavirus Disease Epidemic on the Emergency Medical System in South Korea Using the Korean Triage and Acuity Scale

Abstract

Purpose Severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19), has spread worldwide. Global health systems, including emergency medical systems, are suffering from a lack of medical resources. Using a method for classifying patients visiting the emergency department (ED), we aimed to investigate trends in emergency medical system usage during the COVID-19 epidemic in Korea. Materials and Methods This retrospective observational study included patients who visited emergency medical institutions registered with the National Emergency Department Information System database from January 1, 2017 to May 31, 2020. The primary outcome was identification of changes in the distribution of patients visiting the ED according to the type of emergency medical institution. The secondary outcome was a detailed comparison of Korean Triage and Acuity Scale (KTAS) levels and patient distributions before and during the infectious disaster crisis period. Results Severe patients visited regional emergency centers (RECs) and local emergency centers (LECs) more frequently during the COVID-19 period, and disposition status warranting admission to the intensive care unit or resulting in death was more common in RECs and LECs during the COVID-19 period [RECs, before COVID-19: 300686 (6.3%), during COVID-19: 33548 (8.0%) ( p <0.001); LECs, before COVID-19: 373593 (3.7%), during COVID-19: 38873 (4.5%) ( p <0.001)]. Conclusion During the COVID-19 period, severe patients were shifted to advanced emergency medical institutions, and the KTAS better reflected severe patients. Patient distribution according to the stage of emergency medical institution improved, and validation of the KTAS triage increased more in RECs.

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea – an observational study

“…Our finding is consistent with that of a previous report that the number of emergency department visits by patients with severe medical conditions did not reduce during the COVID-19 pandemic in South Korea. 21 The results of this study indicate that patient response time did not differ significantly across the 3 different epidemic periods of the COVID-19 pandemic, and this finding supports the hypothesis that the COVID-19 pandemic had a limited effect on the healthcare-seeking behavior of patients with STEMI and NSTEMI.…”

“…Our finding is consistent with that of a previous report that the number of emergency department visits by patients with severe medical conditions did not reduce during the COVID-19 pandemic in South Korea. 21…”

“…Previous Korean studies reported decreased number of patient-visit to emergency department (46%-77%) during the early COVID-19 pandemic. 21-23 Therefore, the reduction of the door-to-balloon time could be attributed to decreased emergency care utilisation during the early COVID-19 pandemic as patients with low severity defer emergency department visits owing to the fear of the infection in the medical facility. 22 23 This decrease in emergency care utilisation was also observed during the MERS outbreak in 2015 in South Korea.…”

“…Previous Korean studies reported decreased number of patient-visit to emergency department (46%-77%) during the early COVID-19 pandemic. [21][22][23] Therefore, the reduction of the door-to-balloon time could be attributed to decreased . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Impact of COVID-19 on Emergency Medical Services for Patients with Acute Stroke Presentation in Busan, South Korea

“…Both EDs are regional emergency centers. In a recent South Korean study by Kim et al [ 29 ], during the COVID-19 period, more acute and severe patients have been concentrated in advanced emergency departments, such as regional emergency centers. The concentration of patients in advanced EDs has resulted in a lack of flow and overcrowding of EDs [ 30 ].…”