Evidence map›Paper›PMID 41775276›Full record

ArticleJournal of Korean medical science2026

Delayed at the Door: Impact of Pandemic Response Policies on Emergency and Critical Care in Korea: An Interrupted Time-Series Analysis.

Ho Kyung Sung, Kyung-Shin Lee, Jeehye Lee, Min-Hwan Oh, Jin Young Kim, Young Kyun Choi, Jae Young Moon

Abstract read
In one paragraph

Article in Journal of Korean medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ho Kyung SungNational Emergency Medical Center, National Medical Center, Seoul, Korea.ORCID https://orcid.org/0000-0002-1207-0298
Kyung-Shin LeeCenter for Public Healthcare Policy, National Medical Center, Seoul, Korea.ORCID https://orcid.org/0000-0003-3451-3763
Jeehye LeeDepartment of Preventive Medicine, Konkuk University College of Medicine, Chungju, Korea.ORCID https://orcid.org/0000-0002-9522-1919
Min-Hwan OhGraduate School of Data Science, Seoul National University, Seoul, Korea.ORCID https://orcid.org/0000-0002-8674-5112
Jin Young KimDivision of Respiratory Allergy and Critical Care Medicine, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.ORCID https://orcid.org/0000-0002-7261-7312
Young Kyun ChoiDivision of Infectious Disease, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea.ORCID https://orcid.org/0000-0002-7412-6613
Jae Young MoonDepartment of Pulmonary and Critical Care Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea. diffable@hanmail.net.ORCID https://orcid.org/0000-0001-8724-6289

Funding

Korea Health Industry Development Institute RS-2024-00512375
6 · The paper itself

Abstract

backgroundThe coronavirus disease 2019 (COVID-19) pandemic strained emergency and critical care systems globally, limiting access. Although Korea has been recognized for effective containment, the impact of the pandemic and its response policies on critical care accessibility remains unclear.

methodsWe conducted a nationwide interrupted time-series analysis of patients admitted from emergency department (ED) to intensive care unit (ICU) in Korea (January 2015-December 2023). The study period was divided into pre-pandemic, pandemic phase 1 (January 2020-March 2022; strict infection control with segregated COVID-19 care), and pandemic phase 2 (April 2022 onwards; reintegration of COVID-19 care). Negative binomial regression was used for ED-to-ICU admissions, and seasonal autoregressive integrated moving average models for the proportion of ED length of stay (EDLOS) ≥ 6 hours and in-hospital mortality.

resultsAt pandemic onset, ED-to-ICU admissions declined immediately by 6.66% (95% confidence interval [CI], -9.25 to -3.98) and continued to fall by 0.54% per month (95% CI, -0.69 to -0.39) throughout phase I. Despite this, in-hospital mortality rose by 0.08% monthly (95% CI, 0.02 to 0.14), while EDLOS ≥ 6 hours increased by 0.35% per month (95% CI, 0.24 to 0.47). In phase 2, ED-to-ICU admissions rebounded with a 1.22% monthly increase (95% CI, 0.96 to 1.48), while mortality (-0.10% monthly, 95% CI, -0.20 to -0.01) and EDLOS ≥ 6 hours (-0.98% monthly, 95% CI, -1.18 to -0.77) declined.

conclusionDuring the COVID-19 pandemic, marked changes in Korea's ED-to-ICU admission and in-hospital mortality were observed, reflecting the consequence of pandemic response policies. While infection control was essential, strict segregated COVID-19 care system likely limited ICU access for non-COVID patients, contributing to reduced admissions and increased mortality. These findings underscore the need for policies that balance rigorous infection control with flexible ICU management and effective patient flow strategies during public health emergencies.

Indexed as

COVID-19Critical CareEmergency Service, HospitalHospital MortalityHumansIntensive Care UnitsInterrupted Time Series AnalysisLength of StayPandemicsRepublic of KoreaSARS-CoV-2COVID-19Emergency DepartmentsHospital MortalityIntensive Care UnitsInterrupted Time Series AnalysisPolicy

Identifiers

PMID41775276
PMCPMC12956905

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.