Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study

Abstract

Background: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21-September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21-September 8, 2019) and control period 2 was set as July 1-19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results: During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Impact of junior doctor strikes on patient flow in the emergency department: a cross-sectional analysis

“…This is highlighted by the consistency in patient presentations with lower staffing numbers during strike days. The similar admission, discharge and mortality rates between non-strike and strike days stand in line with previous studies [5,6,9], indicating the admission decisions made by both groups are consistent, but a senior staffing model enables swifter decision making. It is believed that consultants make more timely decisions based on experience, junior to senior doctor discussion time is eliminated, and consultant-to-consultant referrals are better received.…”

“…The impact on healthcare delivery appears to vary between healthcare services: while some are disrupted others experience an increase in efficiency [5][6][7]. In the emergency department (ED), studies of resident doctor strikes in New Zealand and South Korea have shown improved performance, with shorter waiting times, length of ED stay and fewer hospital admissions [7][8][9]. However, data from the 100-day strike of Kenyan physicians in 2016/2017, showed severe disruption and increased mortality across paediatric and obstetric services [10].…”

The impact of health care strikes on patient mortality: A systematic review and meta‐analysis of observational studies

“…After the initial abstract screen (carried out by RE and SMW), 411 articles remained and a second detailed screen was undertaken and reference lists were searched. A further four papers were found, and all 415 articles were assessed against the above eligibility criteria (by RE and SMW), leaving 17 papers that examined mortality [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] (Figure 1). Of these papers, 14 examined in-hospital mortality, while three examined population mortality.…”

Medical students’ professionalism attributes, knowledge, practices, and attitudes toward COVID-19 and attitudes toward care provision during pandemic amidst the COVID-19 outbreak according to their demographics and mental health

“…Furthermore, in August 2020, the medical community went on strike and shut down the country in protest of the expansion of medical school capacity and the establishment of public medical schools. The mass class boycott and strikes in South Korea have raised serious concerns among young doctors and prospective doctors about the professional obligations imposed on healthcare providers during an infectious disease crisis [ 3 ].…”