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. 2019 Aug;60(8):796-803.
doi: 10.3349/ymj.2019.60.8.796.

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

Sun Young Lee  1   2 , Young Ho Khang  1   3 , Hwa Kyung Lim  3
Affiliations

Impact of the 2015 Middle East Respiratory Syndrome Outbreak on Emergency Care Utilization and Mortality in South Korea

Sun Young Lee et al. Yonsei Med J. 2019 Aug.

Abstract

Purpose: In May 2015, South Korea experienced an epidemic of Middle East respiratory syndrome (MERS). This study investigated the impacts of MERS epidemic on emergency care utilization and mortality in South Korea.

Materials and methods: A natural experimental study was conducted using healthcare utilization and mortality data of the entire Korean population. The number of monthly emergency room (ER) visits was investigated to identify changes in emergency care utilization during the MERS epidemic; these trends were also examined according to patients' demographic factors, disease severity, and region. Deaths within 7 days after visiting an ER were analyzed to evaluate the impact of the reduction in ER visits on mortality.

Results: The number of ER visits during the peak of the MERS epidemic (June 2015) decreased by 33.1% compared to the average figures from June 2014 and June 2016. The decrease was observed in all age, sex, and income groups, and was more pronounced for low-acuity diseases (acute otitis media: 53.0%; upper respiratory infections: 45.2%) than for high-acuity diseases (myocardial infarctions: 14.0%; ischemic stroke: 16.6%). No substantial changes were detected for the highest-acuity diseases, with increases of 3.5% for cardiac arrest and 2.4% for hemorrhagic stroke. The number of deaths within 7 days of an ER visit did not change significantly.

Conclusion: During the MERS epidemic, the number of ER visits decreased in all age, sex, and socioeconomic groups, and decreased most sharply for low-acuity diseases. Nonetheless, there was no significant change in deaths after emergency care.

Keywords: Middle East respiratory syndrome (MERS); communicable diseases, emerging; disaster planning; emergency service, hospital.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Trends in emergency room visits between 2014 and 2016. (A) Monthly number of emergency room visits. (B) Ratio of emergency room visits in 2015 compared to the averages in 2014 and 2016.
Fig. 2
Fig. 2. Trends in the ratio of emergency room visits in 2015 compared to the averages in 2014 and 2016 by region. (A) Regional trends in emergency room visits between risk areas and comparison areas. Seoul and Gyeonggi province were risk areas while other metropolitan cities and other provinces were comparison areas. (B) Regional trends in emergency room visits between high-risk areas and comparison areas in Gyeonggi Province. Suwon and Pyeongtaek were high-risk areas while Anyang and Seongnam were comparison areas.
Fig. 3
Fig. 3. Short-term mortality after emergency care between 2014 and 2016. (A) Monthly number of deaths within 7 days of an emergency room visit. (B) Ratio of deaths within 7 days of an emergency room visit in 2015 compared to the averages in 2014 and 2016.
See this image and copyright information in PMC

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