Journal of Yeungnam Medical Science

Original articles

Surgery
Health system disruption and oncologic consequences: a retrospective observational study of South Korea’s 2024 medical walkout: Seung Ho Song, Chang Hyun Kim, Soo Yeun Park; J Yeungnam Med Sci. 2026;43:4. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.4

3,401 View
42 Download
1 Web of Science
2 Crossref

Background
In February 2024, a sudden government policy to drastically increase medical school admissions triggered the mass resignations of medical trainees across South Korea, severely disrupting hospital operations. This study aimed to evaluate the impact of the resulting healthcare workforce disruptions on short-term clinical outcomes and the timing of colorectal cancer surgeries.
Methods
This retrospective comparative study analyzed patients with colorectal cancer treated at two national university hospitals in Daegu and Gwangju, South Korea. Patients who first visited the colorectal surgery department between March and August of 2023 and 2024 were included. Data from 2020 to 2022 were used for extended comparisons. The primary outcome was the interval from initial outpatient visit to surgery. Secondary outcomes included treatment modality distribution, tumor staging, and postoperative complications.
Results
A total of 895 patients in 2023 and 853 in 2024 were included. In 2024, only 39.5% of patients (337/853) underwent upfront surgery compared to 63.5% (569/895) in 2023. The median time to surgery increased from 30 days (interquartile range [IQR], 22–44 days) to 52 days (IQR, 30–72 days) (p=0.001). Clinical T3–4 tumors increased from 49.9% to 59.3% (p=0.018), lymph node-positive cases increased from 25.9% to 51.3% (p=0.001), and postoperative complication rates increased from 12.0% to 28.2% (p=0.001).
Conclusion
The abrupt healthcare workforce crisis in early 2024 significantly delayed colorectal cancer surgeries and was associated with worse short-term oncologic outcomes. These findings highlight the critical importance of maintaining a stable healthcare workforce to protect access to timely cancer care.

Citations

Citations to this article as recorded by

Vascular Anchoring Bias in a Type A Aortic Dissection Survivor: Diagnostic Delays in Acute Care Evaluation of Hepatic and Urologic Pathology
Jason Park, Michail Koutentakis, Issac Park, Emmanuel Faluade, Rodolfo J Oviedo
Cureus.2026;[Epub] CrossRef
Changes in American Society of Anesthesiologists Physical Status Distribution and Prognostic Performance During the 2024 South Korean Healthcare Crisis: A Large-Scale Retrospective Cohort Study
Chan-Sik Kim, Sang-Wook Lee
Journal of Clinical Medicine.2026; 15(11): 4261. CrossRef

Emergency and Critical Care Medicine
Comparing emergency medical system governance in Japan and South Korea: lessons for high-income countries from a multisource comparative health systems analysis: Kentaro Kajino, Jung Ho Kim, Jeong Ho Park, Kyoung-Jun Song, Mohamud R. Daya, Yasuyuki Kuwagata; J Yeungnam Med Sci. 2026;43:3. Published online December 18, 2025; DOI: https://doi.org/10.12701/jyms.2026.43.3

4,200 View
92 Download

Abstract PDF Supplementary Material: Background
Japan and South Korea, two advanced East Asian nations with universal health coverage and similar demographic challenges, have developed markedly different emergency medical services (EMS) systems. Despite growing interest in international benchmarking, structured, comparative studies that yield policy-relevant insights remain limited.
Methods
We conducted a multisource comparative health-systems analysis using statutory laws, government publications, academic society reports, peer-reviewed literature, and national statistics. Key domains included EMS governance, workforce, prehospital organization, hospital-based emergency care, legal obligations for EMS patient transport and hospital acceptance, and governance and quality assurance mechanisms. Data were synthesized in comparative tables and narrative summaries to highlight structural and operational differences.
Results
Japan’s EMS system operates under decentralized municipal control through 722 fire departments, serving 4,100 designated emergency institutions with 6,139 board-certified emergency physicians. In 2023, over 6.64 million ambulance dispatches occurred, and 8.6% were classified as critical cases (1.3% death and 7.3% severe). Korea’s EMS system is centrally governed with 412 designated facilities in a tiered system and 2,464 specialists. Annual ambulance activations exceeded 3.5 million, with severe cases accounting for approximately 5% to 10%. Japan employs a multilayered legal–institutional structure, primarily involving the Fire Service Act and the Medical Practitioners Act, allowing clinical discretion, whereas Korea enforces unified regulations with stricter obligations and criminal penalties for hospital refusal of emergency patients.
Conclusion
The contrasting systems suggest that hybrid governance that combines centralized standard settings with local operational flexibility may optimize EMS performance. These findings provide lessons for EMS reform, cross-border collaboration, and disaster preparedness in high-income nations facing similar demographic and healthcare challenges.

Public Health, Environmental, and Occupational Health
Significant reduction in norovirus outbreaks and secondary transmission of acute gastroenteritis in Seoul schools following the COVID-19 pandemic: a retrospective epidemiological study: Euncheol Son, Young-Hoon Kim; J Yeungnam Med Sci. 2025;42:65. Published online October 14, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.65

1,938 View
80 Download
1 Crossref

Abstract PDF Supplementary Material

Background
Unexpectedly, during the coronavirus disease 2019 (COVID-19) pandemic (2020–2022), it was reported that the number of acute gastroenteritis outbreaks (AGEOs) increased abruptly in childcare centers and kindergartens due to the increase in norovirus GII.4 transmission. However, changes in AGEOs in schools have not been reported during the same period. Therefore, this study aimed to compare the characteristics of AGEOs in schools before and after 2020.
Methods
We analyzed the results of AGEO epidemiological investigation reports in Seoul.
Results
The number of AGEO cases in schools decreased after 2020. Norovirus was identified as the causative pathogen in 10 of 11 cases in 2019, while only five cases were caused by norovirus among the 12 cases between 2020 and 2022. The average attack rate decreased from 10.2% in 2019 to 5.2% between 2020 and 2022. The average duration of patient occurrence also decreased from 7.5 days in 2019 to 4 days between 2020 and 2022. Secondary transmission occurred in all 2019 cases. However, secondary transmission was not observed in half of the cases between 2020 and 2022.
Conclusion
Norovirus outbreaks and secondary transmission in schools declined after the onset of the COVID-19 pandemic, probably because of infection control measures implemented to prevent COVID-19 transmission.

Citations

Citations to this article as recorded by

Sudden pertussis outbreaks in Guro-gu, Seoul: epidemiological characteristics and contributing factors in 2024
Woosuk Han, Heejin Kimm, Yeun Soo Yang, Jun Wook Kwon, Euncheol Son
Child Health Nursing Research.2026; 32(2): 203. CrossRef

Emergency and Critical Care Medicine
Effect of reducing urban road speed limits on motorcyclist traffic accidents: a before-and-after study using the National Emergency Department Information System of South Korea: Seunghyun Baek, Jung Ho Kim; J Yeungnam Med Sci. 2025;42:51. Published online September 1, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.51

1,787 View
57 Download

Abstract PDF: Background
Motorcycles are widely used in various transportation sectors, but riders are directly exposed to external risks. Consequently, motorcyclists are more vulnerable to severe injuries. Road speed limits serve as key policy interventions to mitigate this risk. This study aims to evaluate the effects of reducing urban road speed limits on motorcyclist traffic accidents.
Methods
In this study, National Emergency Department Information System data from the seven largest cities in South Korea were analyzed by comparing a pre-implementation (April 17, 2018 to April 16, 2019) and post-implementation (April 17, 2021 to April 16, 2022) phase. The Pearson chi-square test was used. Additionally, univariable and multivariable logistic regression analyses were performed to assess the effects of the policy on emergency operations, intensive care unit (ICU) admission, and clinical outcomes. Statistical significance was set at p<0.05.
Results
The number of patients decreased from 16,124 to 13,201, along with a reduction in emergency surgeries (n=61) and ICU admissions (n=184); however, unfavorable outcomes increased (n=9). The risk of emergency surgery (adjusted odds ratio [aOR], 1.093; 95% confidence interval [CI], 0.935–1.277) was not statistically significant. However, the risk of ICU admission (aOR, 1.147; 95% CI, 1.015–1.296) and unfavorable outcomes (aOR, 1.502; 95% CI, 1.052–2.145) increased significantly in the post-implementation period.
Conclusion
Although the number of patients significantly decreased, there was no corresponding improvement in clinical outcomes. Instead of abolishing the policy, revising it would be a more appropriate approach. Therefore, additional public interventions and educational programs are required.

Obstetrics, Gynecology, and Reproductive Medicine
Patient-specific predictors of successful frozen embryo transfer using the freeze-all protocol: a retrospective observational study: Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo; J Yeungnam Med Sci. 2025;42:28. Published online February 25, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.28

11,929 View
144 Download
2 Web of Science
2 Crossref

Abstract PDF

Background
The aim of this study was to examine various patient factors affecting first programmed embryo transfer (ET) outcomes under the freeze-all policy at a single tertiary university infertility center.
Methods
This retrospective observational study reviewed the medical records of 243 couples who underwent their first ET using blastocysts collected under the freeze-all antagonist-controlled ovarian stimulation (COS) protocol from 2015 to 2023. Patients were grouped into pregnant and nonpregnant groups, and their data, including demographics, COS and ET outcomes, and embryo storage duration, were analyzed.
Results
Patient body mass index, cause of infertility, follicle-to-oocyte index, distribution of blastocyst grades, number of transferred embryos, and embryo storage duration were not significantly different between the groups. In a simple comparative analysis, patients with successful clinical pregnancy tended to have significantly lower female and male age (33.83±3.67 and 35.32±4.54 years vs. 37.07±4.15 and 39.33±5.60 years, respectively), higher anti-Müllerian hormone levels (6.27±5.32 ng/mL vs. 4.14±3.82 ng/mL) and antral follicle counts (14.20±8.26 vs. 10.04±5.75), and higher numbers of retrieved oocytes and metaphase II oocytes (13.74±6.92 and 9.64±6.19 vs. 11.21±6.04 and 7.53±5.56, respectively). Multivariate logistic regression analysis of these variables revealed that only male age was a significant factor for successful clinical pregnancy (odds ratio, 4.768; 95% confidence interval, 1.252–18.162; p=0.022).
Conclusion
During the first programmed ET using blastocysts collected under the freeze-all antagonist COS protocol, male age and correspondingly the quality of gametes for fertilization were crucial for successful pregnancy, having more importance than calculated female ovarian reserve and embryo storage duration.

Citations

Citations to this article as recorded by

Risk of placenta accreta spectrum in fresh versus natural, stimulated and programmed cycle frozen-thawed embryo transfer
Tomoyuki Fujita, Toshiyuki Yoshizato, Kenta Murotani, Hitoshi Obara, Naotake Tsuda
Reproductive BioMedicine Online.2026; 52(5): 105410. CrossRef
CryoClean technology: A novel closed vitrification system combining high efficiency and sterility for embryo cryopreservation
Rongxiang Wang, Hui Yang, Hongjuan Ye, Laiqing Yan, Liya Shi, Jiwen Zhou, Caixia Zhang, Yu Liu, Kejie Yao, Lihua Sun, Shoulong Deng, Jing Xie, Songguo Xue
Cryobiology.2026; 123: 105644. CrossRef

Review article

Medical Informatics
Digital therapeutics in Korea: current status, challenges, and future directions – a narrative review: Hee Jun Shin, Ik Tae Cho, Wan Suk Choi, Hong Rae Kim, Min Bong Kang, Won Jong Yang; J Yeungnam Med Sci. 2025;42:8. Published online November 18, 2024; DOI: https://doi.org/10.12701/jyms.2024.01004

29,400 View
288 Download
7 Web of Science
10 Crossref

Abstract PDF

Digital therapeutics (DTx) are emerging as a transformative innovation in healthcare offering evidence-based digital interventions for the treatment, management, and prevention of various diseases and disorders. In Korea, DTx have gained significant attention as potential solutions to the increasing burden of chronic diseases and mental health conditions. However, the Korean DTx market faces several challenges that hinder its widespread adoption and integration into the national healthcare system. This study provides a comprehensive analysis of the current state of the DTx market in Korea, identifies the key challenges impeding its growth, and proposes strategies for overcoming these obstacles. This study utilized a literature review and market analysis approach to examine the latest research, industry reports, and regulatory documents related to DTx. The analysis focused on three primary areas: (1) the current regulatory landscape, (2) technological advancements and challenges, and (3) economic and commercial factors influencing DTx adoption in Korea. A comparative analysis of global regulatory practices was also conducted to identify best practices. The findings revealed that while Korea has made significant strides in supporting DTx development, the market remains in its early stages. The key challenges include underdeveloped regulatory frameworks, issues with data quality and security, and a lack of established reimbursement pathways. We recommend developing tailored regulatory frameworks for DTx, enhancing policy support for small and medium-sized enterprises involved in DTx development, and increasing investments in technological infrastructure. By addressing these challenges, Korea could position itself as a leader in the global DTx market, delivering innovative and effective treatments to enhance patient care and outcomes.

Citations

Citations to this article as recorded by

Strategies to Increase Patients’ Adherence to Digital Therapeutics for Musculoskeletal Diseases: A Narrative Review
Myeonghwan Bang, Jung Hyun Park
Yonsei Medical Journal.2026; 67(3): 175. CrossRef
Diving into the Regulatory Landscape of Digital Therapeutics
Madhumitha Masilamani, Melvin George
Therapeutic Innovation & Regulatory Science.2026; 60(3): 725. CrossRef
Comparing mental health professionals’ willingness to use digital therapeutics: a cross-national survey in South Korea and Germany
Daa Un Moon, Shinjae Park, Min-Ji Kim, Stefan Gutwinski, Felix Bermpohl, Malek Bajbouj, Hong Jin Jeon, Alva Lütt
BMC Health Services Research.2026;[Epub] CrossRef
Regulatory Frameworks and Reimbursement Pathways for Digital Therapeutics Medical Devices: A Comparative Policy Analysis of South Korea, Germany, France, and Japan
Chae Yun Kim, Hyun Ji Kim, Jun Yeong Kim, Jeong Kwon Ryu, Hyo Min Yu, Seung Jae Lee, Seong Keun Cho, Yu Kyung Song, Yun Jae Jung, Min Ji Kim, Jong Hyuk Lee
Korean Journal of Clinical Pharmacy.2026; 36(2): 112. CrossRef
Applying a mobile intervention for chronic insomnia in routine care: Study protocol for a multicenter randomized controlled trial
Daa Un Moon, Jeonghun Kim, Jeyoung Hannah Sun, Yujin Lee
Internet Interventions.2025; 41: 100848. CrossRef
Digital Therapeutics for Cognitive Impairment: Exploring Innovations, Challenges, and Future Prospects
Grace Yuange Zang, Keqin Rao, Jing Wu, Yunhan He, Yi Tang, Leiyu Shi
Journal of Medical Internet Research.2025; 27: e73689. CrossRef
Cluster-based quality analysis of mobile health applications based on health behavior theories
Kyong Hee Park, Jeongwon Heo, Hyewon Jang, Youngju Lee, Seoyeon Kim, Hye-Ryoung Kim
Korean Journal of Health Education and Promotion.2025; 42(3): 53. CrossRef
Perceptions and Acceptance of Digital Mental Health Therapeutics Among Psychiatrists
Dahye Jeon, Mose Hwang, Sungmin Son, Taehui Kim, Kyuho Jeong, Aeri Shim, YeonJoo Nam
Journal of Korean Neuropsychiatric Association.2025; 64(4): 306. CrossRef
Musculoskeletal Digital Therapeutics and Digital Health Rehabilitation: A Global Paradigm Shift in Orthopedic Care
Youn Kyu Lee, Eun-Ji Yoon, Tae Hyung Kim, Jong-Ick Kim, Jong-Ho Kim
Journal of Clinical Medicine.2025; 14(23): 8467. CrossRef
Developing and Evaluating Guidelines to Prevent Overdependence on Digital Therapeutics in Children and Adolescents: Randomized Controlled Trial
Euno Kim, Hajae Jeon, Junghan Lee, Hyangkyeong Oh, Meelim Kim, Jaeyong Shin, Eunjoo Kim
Journal of Medical Internet Research.2025; 27: e69248. CrossRef

Original article

Emergency and Critical Care Medicine
Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city: Jung Ho Kim, Hyun Wook Ryoo, Sungbae Moon, Tae Chang Jang, Sang Chan Jin, You Ho Mun, Byung Soo Do, Sam Beom Lee, Jong-yeon Kim; Yeungnam Univ J Med. 2019;36(3):241-248. Published online July 2, 2019; DOI: https://doi.org/10.12701/yujm.2019.00248

10,132 View
84 Download
1 Crossref

Abstract PDF

Background
Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS).
Methods
We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression.
Results
Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102–3.017). The most suitable cutoff point for MHI by Youden’s index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%).
Conclusion
Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.

Citations

Citations to this article as recorded by

Ambient heat exposure and kidney function in patients with chronic kidney disease: a post-hoc analysis of the DAPA-CKD trial
Zhiyan Zhang, Hiddo J L Heerspink, Glenn M Chertow, Ricardo Correa-Rotter, Antonio Gasparrini, Niels Jongs, Anna Maria Langkilde, John J V McMurray, Malcolm N Mistry, Peter Rossing, Robert D Toto, Priya Vart, Dorothea Nitsch, David C Wheeler, Ben Caplin
The Lancet Planetary Health.2024; 8(4): e225. CrossRef

First
Prev
Page of 1
Next
Last

Search