Korea’s 24-hour pediatric 'Friend Clinic' treats 12,000 children in 4 months -- while running monthly deficits

Our Children's Hospital launched the 24-hour "Friend Clinic" to address pediatric healthcare gaps, but its sustainability depends on essential government support.

Chairman Jung Seong-kwan of the Our Children's Medical Foundation held a news briefing last Friday and disclosed the operational status of the Friend Clinic, which has been operating since April 1 at two affiliated hospitals: Our Children's Hospital and Seongbuk Our Children's Hospital.

These are the only two facilities equipped with a 24-hour treatment system for mild pediatric patients.

According to Chairman Jung, approximately 12,600 pediatric patients visited Our Children's Hospital and Seongbuk Our Children's Hospital during medically vulnerable hours from April to July. Medically vulnerable hours are defined as the period from 7 p.m., when pediatric clinics close, until 8 a.m. the following morning.

Analysis of the conditions of children visiting the 24-hour Friend Clinic showed fever was the most common at 56 percent, followed by cough/runny nose (39 percent), and vomiting/diarrhea/abdominal pain (28 percent). Other reasons included hives/rash (5 percent), parental concerns such as fussiness (6 percent), trauma (2 percent), and convulsions/febrile seizures (1 percent).

The most common treatment provided was IV fluids and tests (58 percent), followed by hospitalization (14 percent) and referral to a higher-level hospital (5 percent). Cases requiring active intervention accounted for 77 percent. The remaining 23 percent were treated with oral medication prescriptions only.

“The number of patients visiting the Friend Clinic is increasing over time,” Chairman Jung stated. “This result demonstrates that the demand for nighttime and early morning care for mild to moderate pediatric patients is much higher than anticipated. It proves the necessity of a 24-hour pediatric care system.”

Chairman Jung explained that discussions with professors at nearby university hospital emergency rooms confirmed a definite decrease in mild pediatric patients, effectively creating a structure allowing tertiary hospitals to focus more on treating severe cases. “This represents a meaningful achievement in alleviating the burden on community emergency rooms and enhancing treatment efficiency,” he noted.

Notably, the number of new pediatric patients increased significantly as the night progressed.

At Our Children's Hospital, 6,397 patients visited from April to July, of whom 1,952 (30.5 percent) were new patients. Of these new patients, 41 percent were concentrated between 10 p.m. and 9 a.m. the following morning. At Seongbuk Our Children's Hospital, 28.3 percent (1,741) of the total 6,144 pediatric patients were new patients, with 48 percent of these visiting late at night.

The geographic distribution of patients visiting these hospitals is also expanding. Primarily during daytime hours, patients from the “near catchment area” visited, while at night and late at night, this expanded to the “wider catchment area.” Patients are now visiting not only from Seoul's southwest and northeast regions but from across the entire metropolitan area.

“The fact that new patient influx increases during vulnerable hours highlights gaps in essential pediatric care within the community,” said Dr. Baek Jung-hyun, director of Our Children's Hospital. “Systemic support at the government level and a realistic redesign of the essential healthcare system are necessary.”

Kim Min-sang, Chief Strategy Officer (CSO) of the Our Children's Medical Foundation, also noted, “The Friend Clinic functions not merely as extended-hours care, but as a ‘substitutable medical hub’ across regions lacking access to nighttime pediatric care.”

While the Friend Clinic operates as a safety net, filling pediatric care gaps, it incurs monthly deficits of tens of millions of won. Staffing for 24-hour hospital operations is also substantial. Yet government support remains woefully inadequate; increased, sustained funding is urgently needed to maintain essential pediatric services.

Chairman Jung explained, “The manpower required for 24-hour care alone is substantial. Not only doctors, but nurses, nursing assistants, clinical laboratory technicians, radiologists, parking attendants, and administrative/support staff must be deployed. The facilities team must also manage the building, electricity, and elevators throughout the night.”

He continued, “We received a payment after being designated as an essential hospital, but it was only about one-tenth of what we expected. As a result, we continue to run a significant monthly deficit.”

Our Children's Hospital and Seongbuk Our Children's Hospital were selected last July for the “Essential Specialized Function Enhancement Support Project” in the pediatric and adolescent medicine field. The government supports secondary medical institutions with specialized capabilities and night- and holiday-care systems for specific medical fields, serving as essential specialized hospitals to fill gaps in medical care in regions.

However, Our Children's Medical Foundation stated that it will continue investing in the 24-hour Friend Clinic model to fill gaps in nighttime and late-night pediatric care and to establish a stable medical safety net.

Chairman Jung stated, “With the recent flu season starting two months earlier than usual, we've had nights where over 130 patients visited the hospital,” adding, “We plan to hire additional dedicated staff so that eight personnel can be stationed at each hospital.”

He emphasized, “For the 24-hour Friend Clinic model to succeed and expand to rural areas, the government must provide direct, ongoing financial support specifically designated for staffing, infrastructure, and operational expenses.”