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Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study.
J Korean Med Sci. 2021 Apr 26; 36(16):e121.JK

Abstract

BACKGROUND

The purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period.

METHODS

This study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak.

RESULTS

The number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74-0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57-0.83) for the patients with acute myocardial infarction and 0.76 (0.67-0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: -5.3 [-6.5 to -4.2] minutes in phase 5 compared to phase 3).

CONCLUSION

Implementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing in-hospital mortality by preventing excessive deaths.

Authors+Show Affiliations

National Emergency Medical Center, National Medical Center, Seoul, Korea.National Emergency Medical Center, National Medical Center, Seoul, Korea. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea. ro.youngsun@gmail.com.National Emergency Medical Center, National Medical Center, Seoul, Korea.National Emergency Medical Center, National Medical Center, Seoul, Korea.National Emergency Medical Center, National Medical Center, Seoul, Korea.National Emergency Medical Center, National Medical Center, Seoul, Korea.Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea. docheo@hanmail.net.National Emergency Medical Center, National Medical Center, Seoul, Korea. Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33904264

Citation

Pak, Yun Suk, et al. "Effects of Emergency Care-related Health Policies During the COVID-19 Pandemic in Korea: a Quasi-Experimental Study." Journal of Korean Medical Science, vol. 36, no. 16, 2021, pp. e121.
Pak YS, Ro YS, Kim SH, et al. Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study. J Korean Med Sci. 2021;36(16):e121.
Pak, Y. S., Ro, Y. S., Kim, S. H., Han, S. H., Ko, S. K., Kim, T., Kwak, Y. H., Heo, T., & Moon, S. (2021). Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study. Journal of Korean Medical Science, 36(16), e121. https://doi.org/10.3346/jkms.2021.36.e121
Pak YS, et al. Effects of Emergency Care-related Health Policies During the COVID-19 Pandemic in Korea: a Quasi-Experimental Study. J Korean Med Sci. 2021 Apr 26;36(16):e121. PubMed PMID: 33904264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study. AU - Pak,Yun Suk, AU - Ro,Young Sun, AU - Kim,Se Hyung, AU - Han,So Hyun, AU - Ko,Sung Keun, AU - Kim,Taehui, AU - Kwak,Young Ho, AU - Heo,Tag, AU - Moon,Sungwoo, Y1 - 2021/04/26/ PY - 2020/12/24/received PY - 2021/04/06/accepted PY - 2021/4/27/entrez PY - 2021/4/28/pubmed PY - 2021/5/4/medline KW - COVID-19 KW - Emergency Care Policies KW - Quasi-experimental Study SP - e121 EP - e121 JF - Journal of Korean medical science JO - J Korean Med Sci VL - 36 IS - 16 N2 - BACKGROUND: The purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period. METHODS: This study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak. RESULTS: The number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74-0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57-0.83) for the patients with acute myocardial infarction and 0.76 (0.67-0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: -5.3 [-6.5 to -4.2] minutes in phase 5 compared to phase 3). CONCLUSION: Implementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing in-hospital mortality by preventing excessive deaths. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/33904264/Effects_of_Emergency_Care_related_Health_Policies_during_the_COVID_19_Pandemic_in_Korea:_a_Quasi_Experimental_Study_ L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2021.36.e121 DB - PRIME DP - Unbound Medicine ER -