The Medical Innovation Committee has recommended that the government send critically ill emergency patients directly to specialized hospitals capable of performing the surgery or procedures they actually need, rather than to the nearest emergency room. The committee also proposed overhauling how emergency medical institutions are designated and evaluated, shifting the focus from whether they have the required facilities and staff to whether they can actually perform emergency surgery and treat critically ill patients.
The committee discussed the recommendations, titled a government advisory on the timely transport and treatment of emergency patients, at its 10th meeting on the 1st. It said the emergency care system should be restructured so that every stage — from the moment an emergency occurs through transport, emergency room care and definitive treatment such as surgery and procedures — works as a single connected process.
The committee first recommended that the receiving hospital be chosen based on the severity of the patient's condition and the treatment required. Patients needing specialized care, such as those with severe trauma, cardiovascular or cerebrovascular disease, or women in labor, would be taken directly to an emergency institution able to provide that treatment. Backup transport routes would be arranged in advance in case the first hospital cannot accept the patient.
The roles of emergency institutions would also be redivided. Regional emergency medical centers would concentrate on definitive treatment for critically ill patients, including emergency surgery and intensive care, while local emergency medical centers would provide backup specialist and surgical treatment within their areas. Local emergency medical institutions would treat patients with mild conditions and, if a case proves severe, stabilize the patient before transferring them to a higher-level facility.
The committee also called for revising how emergency institutions are designated and evaluated. In addition to existing standards for facilities and staff, assessments would center on whether an institution actually provides emergency surgery and intensive care. Institutions unable to meet the requirements would have their functions adjusted or would be required to set up referral and transfer arrangements with higher-level hospitals. At a briefing, committee chair Jeong Ki-hyun said options such as reclassifying a regional center as a local center were possible, but added that revoking a designation required caution given the risk of gaps in care.
The committee found that while the number of emergency care workers is rising, backup care such as surgery and intensive care is not keeping pace. It estimated that only 55.8% of institutions can handle emergency surgery around the clock. Rather than spreading a limited pool of specialists across many hospitals, the committee proposed strengthening regional capacity around hub institutions through rotating on-call duty, joint operations and secondment agreements.
Alternative care options would also be expanded so that non-emergency patients can avoid the emergency room at night and on holidays. Local hospitals and clinics would extend outpatient hours during those times, and participating institutions would receive higher fees by time of day along with operating support. The committee also proposed extending an urgent care model, similar to the Moonlight Children's Hospital program for pediatric patients, to other fields of medicine.
The 119 emergency dispatch centers, the National Emergency Medical Center and emergency institutions would be linked in real time to share information on treatment availability, including beds, operating rooms, intensive care units and whether specialists are on call. The committee also recommended the phased expansion of artificial intelligence tools to support analysis and decision-making in emergency transport, following pilot projects and policy research.
"The core of reforming the emergency care system is making sure emergency patients are quickly taken to an appropriate hospital and can receive definitive treatment, including surgery and intensive care," Jeong said. "I hope this becomes a turning point toward a system in which people can get the emergency care they need, when they need it, wherever they live."
