Chuseok ER shuttling feared as most regions skip mandatory admission rules

As the long Chuseok holiday approaches, concerns are mounting that the government's measures to prevent “emergency room runaround” may be ineffective in practice at regional medical sites.

According to data submitted to Rep. Kim Sun-min of the Rebuilding Korea Party, a member of the National Assembly's Health and Welfare Committee, by the National Medical Center on Monday, 67,782 patients visited emergency rooms during last year's Chuseok holiday period, with 402 fatalities.

Among the fatalities, 305 died inside the emergency room, while 97 died before arriving there.

The surge of patients to emergency rooms during the Chuseok holiday also led to a significant increase in transfers. Data released earlier this month by the National Assembly Research Service showed that last year, 5,657 emergency room transfers were recorded—a 33.8 percent increase compared to the previous year.

However, while all 17 metropolitan and provincial governments nationwide established guidelines for transporting and accepting emergency patients in accordance with directives from the Ministry of Health and Welfare, only six included mandatory acceptance clauses.

Last year, to prevent ER runaround, the ministry sent the “Standard Guidelines for Notifying Difficulties in Emergency Room Admission and Transfer Guidelines” to the 17 provincial and metropolitan governments. Based on resource surveys by each metropolis and province, they were tasked with developing guidelines tailored to their respective regions.

The core of the ministry’s guidelines is that “when a severe emergency patient arises but all emergency medical institutions notify that admission is difficult, a hospital must be designated (priority admission hospital) to mandatorily admit the patient according to pre-agreed criteria.”

According to data Rep. Kim received from the ministry, as of Sept. 12, all 17 provincial and metropolitan governments had established and implemented transfer and admission guidelines. However, only Daegu, Incheon, Gwangju, Gyeonggi, Gangwon, and South Gyeongsang provinces had obligatory acceptance provisions. The remaining 11 local governments are operating transfer and admission guidelines that omit the key clause requiring hospitals to accept emergency patients.

“The obligation to admit emergency patients is not legally binding under the current Emergency Medical Services Act,” a ministry official said. “It is based on guidelines established and operated by each metropolitan or provincial government. Therefore, the Ministry of Health and Welfare lacks the authority to compel large autonomous local governments.”

Kim emphasized that the ministry must prepare practical measures to prevent ER runaround by supplementing the guidelines and revising the law.

“The Health and Welfare Ministry must ensure that mandatory admission measures for emergency patients are reflected in the guidelines through continuous consultation with metropolitan governments,” Kim said. “If necessary, it should immediately review amendments to the Emergency Medical Services Act incorporating these mandatory provisions to take substantive action preventing further ER shuttling.”