J Korean Med Sci.  2021 Jul;36(28):e204. 10.3346/jkms.2021.36.e204.

Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Medical Use of Military Hospitals in Korea

• Yoon D
• Kim KE
• Lee JE
• Kim M
• Kim JH

• KMID: 2518526
• DOI: http://doi.org/10.3346/jkms.2021.36.e204

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic began in December 2019. While it has not yet ended, COVID-19 has already created transitions in health care, one of which is a decrease in medical use for health-related issues other than COVID-19 infection. Korean soldiers are relatively homogeneous in terms of age and physical condition. They show a similar disease distribution pattern every year and are directly affected by changes in government attempts to control COVID-19 with nonpharmaceutical interventions. This study aimed to identify the changes in patterns of outpatient visits and admissions to military hospitals for a range of disease types during a pandemic.
Methods
Outpatient attendance and admission data from all military hospitals in South Korea from January 2016 to December 2020 were analyzed. Only active enlisted soldiers aged 18–32 years were included. Outpatient visits where there was a diagnosis of pneumonia, acute upper respiratory tract infection, infectious conjunctivitis, infectious enteritis, asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, urticaria, and fractures were analyzed. Admissions for pneumonia, acute enteritis, and fractures were also analyzed. All outpatient visits and admissions in 2020 for each disease were counted on a weekly basis and compared with the average number of visits over the same period of each year from 2016 to 2019. The corrected value was calculated by dividing the ratio of total weekly number of outpatient visits or admissions to the corresponding medical department in 2020 to the average in 2016–2019.
Results
A total of 5,813,304 cases of outpatient care and 143,022 cases of admission were analyzed. For pneumonia, the observed and corrected numbers of outpatient visits and admissions in 2020 decreased significantly compared with the average of other years (P < 0.001). The results were similar for outpatient visits for acute upper respiratory tract infection and infectious conjunctivitis (P < 0.001), while the corrected number of outpatient visits for infectious enteritis showed a significant increase in 2020 (P = 0.005). The corrected number of outpatient visits for asthma in 2020 did not differ from the average of the previous 4 years but the number of visits for the other allergic diseases increased significantly (P < 0.001). For fractures, the observed and corrected numbers of outpatient visits and admissions in 2020 decreased significantly compared with the average of other years (P < 0.001).
Conclusion
During the COVID-19 pandemic, outpatient visits to military hospitals for respiratory and conjunctival infections and fractures decreased, whereas visits for allergic diseases did not change or increased only slightly. Admissions for pneumonia decreased significantly in 2020, while those for acute enteritis and fractures also decreased, but showed an increased proportion compared with previous years. These results are important because they illustrate the changing patterns in lifestyle as a result of public encouragement to adopt nonpharmaceutical interventions during the pandemic and their effect on medical needs for both infectious and noninfectious diseases in a select group.

Keyword

COVID-19; South Korea; Military Personnel; Nonpharmaceutical Intervention

Figure

• 

  Fig. 1 The weekly number of outpatient visits for each disease is plotted by year to show seasonal variation and the difference between 2020 and 2016–2019; the mean values for 2016–2019 are also shown: (A) pneumonia, (B) acute upper respiratory tract infection, (C) infectious conjunctivitis, (D) infectious enteritis, (E) asthma, (F) allergic rhinitis, (G) allergic conjunctivitis, (H) urticaria, (I) atopic dermatitis, and (J) fractures.

• 

  Fig. 2 The weekly number of admissions for each disease is plotted by year to show seasonal variation and the difference between 2020 and 2016–2019; the mean values for 2016–2019 are also shown: (A) pneumonia, (B) infectious enteritis, (C) fractures.

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