Lack of regional hospital infrastructure blamed for preventable deaths

The lack of medical infrastructure in rural areas is causing delays for patients seeking medical treatment, leading to death in some cases.

An ambulance drives by a university hospital in Seoul on Feb. 18. [NEWS1]

The lack of medical infrastructure in rural areas is causing delays for patients seeking medical treatment, leading to death in some cases.

The Ministry of Health and Welfare is investigating the death of a woman in her 70s in North Chungcheong whose treatment was denied by four hospitals.

According to the fire department, a telephone pole fell onto the woman at 5:11 p.m. on March 22 after a tractor crashed into it.

An emergency medical team arrived at 5:21 p.m. and rescued the woman, who was found to have severely injured her back and leg.

After rescuing the woman, the emergency team immediately searched for hospitals that could treat the injured woman.

“When the emergency team arrived, the woman had a fracture on her left ankle and complained of back pain, but it was clear that she was conscious,” a North Chungcheong fire official said.

“We used North Chungcheong’s medical emergency system device, which helps assign patients, to request a transfer to two hospitals — Konkuk University Chungju Hospital and Chungju Medical Center — as we thought that she needed surgery immediately.”

However, both medical institutions rejected her, the fire department said.

Konkuk University Chungju Hospital rejected her, saying that it “does not have an anesthetist,” while Chungju Medical Center said that “it is unable to proceed with a surgery for her,” adding that “microfracture injuries should be transferred to a bigger hospital or an external trauma center where microvascular surgery is possible.”

After being rejected by two hospitals, the emergency team transferred the woman to a hospital in downtown Chungju, which was 18.6 kilometers (11.6 miles) away from the accident site.

The team thought the hospital would be able to treat her leg, as it practices internal medicine, plastic surgery and rehabilitation medicine.

The hospital treated her for the microfracture, but abdominal bleeding was discovered during the operation. As this hospital did not have a surgical expert who could treat this condition, the woman needed to visit another hospital.

The hospital medical team then asked Yonsei University Wonju Severance Christian Hospital to accept the woman’s transfer, but was denied, as it already had two patients on its waiting list.

The medical team also added that it called Chungbuk National University Hospital several times, but the hospital did not pick up.

A Chungbuk National University Hospital spokesperson said that “it did not receive any request regarding the patient’s transfer, while its medical team for its trauma center and emergency room were both on duty.”

The patient ended up being transferred to Ajou University Hospital in Suwon, Gyeonggi, about 100 kilometers away from Chungju, at 1:50 a.m. the next day.

She was pronounced dead at 2:22 a.m., the same day she was transferred to Suwon. It was nine hours after the accident.

At the time of the accident, most of the junior doctors from general hospitals Wonju Severance Christan Hospital and Chungbuk National University Hospital were on strike, leaving their posts empty.

However, it has not been confirmed whether her rejection was caused by the shortage of medical labor due to the junior doctors’ walkout.

The Health Ministry and North Chungcheong provincial office are now looking into her case to investigate whether the hospitals’ measures were appropriate and whether the outcome was related to recent strikes.

A provincial office spokesperson said that “it is examining if the case has any causal relationship with the medical field’s collective act based on the hospitals’ medical records.”

Rising cases of emergency patients failing to get proper treatment has raised questions about the medical infrastructure in North Chungcheong.

Out of the 17 local regions, North Chungcheong had the highest number of treatable deaths per 100,000 population, with 50, according to the Health Ministry’s 2022 national health survey report.

The region also ranked 14th out of the 17 when it came to the number of doctors per 1,000 people, having 1.57 doctors. The figure is far less than the national average of 2.13 doctors per 1,000 people.

According to a medical service report by the Chungbuk Research Institute, a total of 21 emergency medical institutions were assigned to the North Chungcheong region following the Emergency Medical Service Act.

Currently, the region has one regional emergency medical center, five local emergency medical centers, nine local emergency medical service institutions and six institutions with emergency rooms that are not designated as emergency medical service institutions by the government.

The facilities are largely concentrated in Cheongju, North Chungcheong, with seven of them located in the city.

Some counties in North Chungcheong, including Boeun, Jeungpyeong, and Danyang, do not have any emergency medical service institutions within 15 kilometers.

Among the 11 cities and counties of North Chungcheong, six areas do not have a general hospital that can handle all types of medical and surgical cases.

On March 30, a 33-month-old girl fell into a pool of water in Boeun County, North Chungcheong, but died 3 hours and 10 minutes after police received the accident report, as she was unable to get proper treatment.

The girl was rejected by 10 general hospitals.

BY CHOI JONG-KWON, KIM JI-YE [kim.jiye@joongang.co.kr]