The number of pediatric patients’ emergency room visits has increased by 61 percent since the mask mandate was lifted, according to a new study. 

To avoid paralyzing emergency care departments due to a surge in patients, the government should take various steps, including raising medical fees to realistic levels, the study said.

A team of Ulsan National University College of Medicine researchers analyzed 18,654 patients aged 18 and younger who visited pediatric emergency medical centers between Jan. 1, 2022, and June 30, 2023. The team published their findings in the latest Pediatric Emergency Medicine Journal (PEMJ) issue.

The team defined the period from March 20, 2023, when the government announced masks were no longer mandatory, to June 30, 2023, as the post-masking period and the same period of a year earlier year as the masked period.

The results showed a 61.0 percent growth in patients before and after lifting the mask mandate. In terms of age, patients aged 2-5 years had the highest increase of 82.9 percent. In terms of severity, stage 3 mild patients saw the largest increase, while the share of hospitalized patients decreased from 9.6 percent to 6.0 percent. They also found a significant increase in visits on Fridays and Saturdays.

The two days of the week marked a 30-fold increase in the frequency of visits of 10 or more patients per hour, exacerbating emergency department congestion.

Infectious disease patients marked an increased ratio of 2.9, with the highest increase among 2-5-year-olds, but that of 6-11-year-olds and 12-18-year-olds recorded the sharpest growth in their shares. There was also an increase in infectious disease patients visiting at night, and those who stayed fewer than three hours recorded the highest increase in rates and shares.

Compared to the number of specialists on duty in the ERs, the period of the two-physician system saw a larger share of minor and infectious disease patients and a higher proportion of patients sent home rather than hospitalized. When there were two physicians in the ERs, the number of patients visiting per hour was higher than during the one-physician period, but their length of stay was shorter.

"In particular, there was a 30-fold increase in the frequency of 10 or more patients visiting per hour, which can compromise ER safety during a temporary disaster, and needs to be addressed," the researchers said. "In the short term, increasing the number of specialists could reduce patient length of stay and improve safety. In the long term, expanding emergency care infrastructure for minor injuries is necessary by raising fees for pediatric, late-night, holiday, and weekend treatment to realistic levels."

The study pointed out that specialists should compensate for the shortage of medical residents.

“Assuming that a pediatric emergency medicine specialist works less than 30 hours per week, including nights, weekends, and holidays, it can be estimated that for every shortage of one medical resident, two or three specialists are needed," it said. "Active and realistic measures are needed by health authorities to address patient safety in emergency departments."