Emergency medical system on brink as patient refusals, delays soar

The number of emergency rooms notifying patients of capacity issues nearly doubled last year due to the fallout from the government–doctor conflict triggered by efforts to expand medical school enrollment quotas, and the time taken to reach hospitals also increased.

According to data submitted to Rep. Seo Young-seok of the Democratic Party of Korea by the Ministry of Health and Welfare, the number of pre-notifications that emergency rooms were unable to accept patients increased by 88 percent, from 58,520 cases in 2023 to 110,333 cases in 2024. As of August, 83,181 similar cases have already occurred this year, suggesting that the year-end figure will surpass last year's total.

The time it takes for emergency patients to reach hospitals (including waiting and transport) is also increasing.

Fire Department data showed that in 2023, only 1.9 percent of the 1.79 million total transports exceeded 30 minutes to reach a hospital. However, the comparable rate rose to 3.8 percent in 2024 and 5.4 percent in the first half of this year, nearly tripling over the three-year period. Notably, last year saw an 80.3 percent year-on-year increase in cases where the time from paramedics' arrival at the scene to the patient's arrival at the hospital exceeded 120 minutes.

Rep. Seo pointed out that the measures the government is promoting to improve the emergency medical delivery system are unlikely to be effective.

Seo stated that the “Standard Guidelines for Managing Emergency Room Capacity Notification” distributed last April lack legal enforceability, making it impossible to statistically track violations. Furthermore, while the number of ambulance dispatch centers nationwide is expected to increase to 20 by 2025, with staffing rising to 395 personnel and over 90 billion won ($64.5 million) allocated in the budget, there is a complete lack of data to verify improvements in patient assignment and transport efficiency.

He also referenced a National Assembly Research Service report, emphasizing the need to strengthen the authority of the 119 Emergency Dispatch Centers to decide on patient transfer to hospitals and establish a legal basis for building an integrated information system.

“The worsening emergency room patient refusals and ambulance re-transfers caused by the Yoon Suk Yeol administration's healthcare crisis are serious signals of the collapse of the emergency medical system,” Seo said. “If the government cannot guarantee effectiveness on the ground despite investing hundreds of billions of won and hundreds of personnel annually, this is a clear dereliction of duty. An institutional foundation that citizens can trust and rely on in critical moments must be established promptly.”