Kim Youngsoo, Park Dougho, Kim Haemin, Koo Dahyeon, Lee Sukkyoung, Min Yejin, Hong Daeyoung, Kim Mun-Chul
Department of Neurosurgery, Pohang Stroke and Spine Hospital, Pohang 37659, Republic of Korea.
Medical Research Institute, Pohang Stroke and Spine Hospital, Pohang 37659, Republic of Korea.
Healthcare (Basel). 2025 Aug 27;13(17):2129. doi: 10.3390/healthcare13172129.
: In February 2024, a nationwide resignation of resident physicians and fellows in South Korea caused a sudden disruption in the healthcare service delivery system. This study aimed to investigate how the crisis affected hospital admission patterns, treatment timelines, and early outcomes in patients with acute hemorrhagic stroke. : We retrospectively analyzed data from prospective cohorts of patients diagnosed with intracerebral hemorrhage or subarachnoid hemorrhage admitted to a single cerebrovascular-specialty hospital between March 2023 and February 2025. Patients were categorized into two groups: those admitted before (Before crisis group, = 130) and after (After crisis group, = 214) the crisis. Clinical characteristics, regional distribution, time delays, and 3-month modified Rankin Scale (mRS) outcomes were compared. : Following the crisis, a significant increase was observed in admissions from outside the hospital's primary coverage area ( < 0.001). Onset-to-arrival (138.0 vs. 92.0 min, = 0.040) and onset-to-operation times (200.0 vs. 166.0 min, = 0.046) were significantly delayed, particularly in patients who underwent surgical treatment. However, arrival-to-operation time remained stable ( = 0.694), and initial neurological severity was comparable. Functional outcomes at 3 months did not differ significantly (mRS 0-2: 53.8% vs. 50.5%, = 0.157), indicating preserved in-hospital care quality, despite external disruption. : The medical crisis disrupted the stroke care delivery system and delayed prehospital care in South Korea. Nevertheless, the cerebrovascular-specialty hospital maintained timely intervention and preserved outcomes. These findings support the strategic importance of decentralized specialty hospitals in ensuring the resilience of the healthcare service delivery system during a national healthcare crisis.
2024年2月,韩国住院医师和研究员的全国性辞职导致医疗服务提供系统突然中断。本研究旨在调查这场危机如何影响急性出血性中风患者的住院模式、治疗时间线和早期预后。我们回顾性分析了2023年3月至2025年2月期间入住一家单一脑血管专科医院的诊断为脑出血或蛛网膜下腔出血的前瞻性队列患者的数据。患者分为两组:危机前入院的患者(危机前组,n = 130)和危机后入院的患者(危机后组,n = 214)。比较了临床特征、区域分布、时间延迟和3个月改良Rankin量表(mRS)结局。危机后,医院主要覆盖区域外的入院人数显著增加(P < 0.001)。发病到到达时间(138.0对92.0分钟,P = 0.040)和发病到手术时间(200.0对166.0分钟,P = 0.046)显著延迟,尤其是接受手术治疗的患者。然而,到达手术时间保持稳定(P = 0.694),初始神经严重程度相当。3个月时的功能结局没有显著差异(mRS 0 - 2:53.8%对50.5%,P = 0.157),表明尽管受到外部干扰,但住院护理质量得以保持。这场医疗危机扰乱了韩国的中风护理提供系统并延迟了院前护理。尽管如此,脑血管专科医院仍保持了及时的干预并维持了预后。这些发现支持了在全国医疗危机期间,分散的专科医院对于确保医疗服务提供系统弹性的战略重要性。