{
  "abstract": "Background/Objectives: Emergency department (ED) attendance may change differently from subsequent hospital utilisation during healthcare disruptions. We compared two historical crisis episodes within one Korean regional emergency medical centre. Methods: Four calendar-aligned 224-day windows before and after the onset of COVID-19 and the 2024 workforce disruption were analysed using episode-by-phase interactions. Modified Poisson models used patient-and-day two-way clustered variance. Less-conditioned and initial-acuity-conditioned models were compared. Daily counts used calendar-lag autocorrelation-consistent variance. Source-data audits, full-period segmented analyses and alternative-baseline sensitivities were added. Results: The windows included 83,998 visits by 66,096 patients after source-data recoding. The ratio of relative changes was 0.73 (95% confidence interval [CI], 0.68–0.78) for daily visits, 1.28 (1.19–1.37) for transfer-in presentation and 1.44 (1.33–1.55) for acuity-conditioned ICU admission. EMS arrival increased more during COVID-19, but the corrected physiological composite showed no clear between-episode contrast. ED-origin ICU admissions/day were 9.24 before and 9.67 during the workforce episode; the primary ratio of incidence rate ratios was 1.13 (1.05–1.22), but the prior-calendar-year sensitivity included the null (1.06, 0.97–1.15). Workforce-period mortality associations differed before and after acuity conditioning, with adjusted risk ratios of 1.28 (1.10–1.49) and 1.06 (0.92–1.22), respectively. Conclusions: Attendance contracted more than ED-origin ICU admission volume during the observed workforce episode. These findings describe utilisation, not measured capacity pressure, and depend partly on baseline and adjustment choices. The contribution is a multidimensional approach to utilisation surveillance, not universal crisis-specific effects or evidence of unchanged survival.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Chan Park",
      "orcid": "0009-0005-0962-6071"
    },
    {
      "affs": [
        0
      ],
      "name": "Kang Hyun Lee",
      "orcid": "0000-0001-9664-9186"
    },
    {
      "affs": [
        0
      ],
      "name": "Oh Hyun Kim",
      "orcid": "0000-0002-8415-0318"
    },
    {
      "affs": [
        0
      ],
      "name": "Sun Ju Kim",
      "orcid": "0000-0002-8169-5750"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7ecm5rwpjed1t.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207783",
  "fulltext_url": null,
  "id": "7ecm5rwpjed1t",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7783",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2711|Emergency and Acute Care Studies"
    ]
  ],
  "openalex": "W7221096967",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/7ecm5rwpjed1t.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207783",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7783"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2711|Emergency and Acute Care Studies",
      "subfield": "general"
    }
  ],
  "title": "Emergency-Care Utilisation During Two Healthcare Crises in South Korea: A Single-Centre Comparison of Calendar-Aligned 32-Week Windows",
  "title_text": "Emergency-Care Utilisation During Two Healthcare Crises in South Korea: A Single-Centre Comparison of Calendar-Aligned 32-Week Windows",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:00Z",
  "url": "https://research.draconitic.com/paper/7ecm5rwpjed1t",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}