Analysis of the impact of the COVID-19 epidemic on the emergency medical system in the South Korea using the Korean Triage and Acuity Scale (KTAS)

Introduction The severe acute respiratory syndrome corona virus 2(SARS-CoV-2) which was called coronavirus disease 2019(COVID-19) has spread worldwide. Global health system including emergency medical system is on suffering as lack of medical resources. Corona 19 has also spread widely in Korea, and the emergency medical system has changed through the spread of the infectious disease crisis stage. Through Korean Triage and Acuity Scale (KTAS), a system for classifying patients who visited the emergency department, we intend to verify the trend and validation of the emergency medical system during the COVID-19 period. Material & Method This study is a retrospective observational study conducted from January 1, 2017 to May 31, 2020 in patients who visited the emergency medical institutions registered with NEDIS. (National Emergency Department Information System) database. The reference time point is before and after January 28, 2020, when the infectious disease crisis stage was declared ‘Orange’. The primary outcome is to identify changes in distribution of the patients visited at emergency department (ED) according to each stages of emergency medical institutions. during the infectious disaster crisis compare with previous period and the secondary outcome is to conduct detailed analysis through comparison of KTAS level and patient distribution following disposition status at ED. Result Of all patients, 14,983,848 patients visited ED before COVID-19 and 1,281951 patients visited during the COVID-19 period. There is no statistical difference in the distribution of visiting emergency medical institutions before and during COVID-19 period. Severe patients had visited more during COVID-19 period in regional emergency center (REC) and local emergency center (LEC) and disposition status to admission to intensive care unit or expire had more distributed in REC and LEC during COVID-19. Conclusion During the COVID-19 period, severe patients were shifted to advanced emergency medical institution and KTAS better reflected severe patients. Patients distribution by the stage of emergency medical institution was improved and validation of KTAS triage more increased in REC.