Gov't plans nationwide rollout of emergency coordination centers after regional pilot program ends 'ER ping-pong'

A pilot program that shifts the task of finding available hospitals from paramedics to regional emergency coordination centers eliminated all cases of so-called ER ping-pong — in which emergency patients are repeatedly turned away by hospitals while paramedics search for a facility that can accept them — in western regions of Korea over the past three months, according to government data released on Sunday.

One example came on April 16, when a critically injured burn patient in South Jeolla was unable to find a hospital despite paramedics contacting two facilities. After a request for assistance, a regional emergency coordination center located a specialized burn hospital in another province and arranged the transfer within seven minutes.

The Ministry of Health and Welfare and the National Fire Agency announced that key indicators, such as the amount of time paramedics spent at emergency scenes and the processing time at regional emergency coordination centers, improved during the March to May pilot period. The government plans to use the pilot program's results to revamp emergency patient transfer guidelines nationwide and implement the revised system by September.

The centerpiece of the pilot was a new system designed to eliminate the need for paramedics to spend crucial response time calling hospitals one by one to find emergency rooms available for intake.  

Under the previous system, when an emergency patient required treatment, paramedics or emergency dispatch centers had to contact hospitals individually to determine whether they could accept the patient. If multiple hospitals declined, transfers were delayed and often prevented patients from receiving timely care.

The pilot program was tailored by region to consider local factors such as medical infrastructure and population.

For example, in Gwangju, authorities established a committee dedicated to transferring severe emergency patients, consisting of on-duty physicians at six emergency medical institutions, paramedics and the regional emergency coordination center. During the pilot period, the committee intervened in 27 delayed patient transfer cases.

North Jeolla utilized a system that allowed paramedics and hospitals to quickly exchange patient information and confirm whether hospitals could accept patients.

South Jeolla, where medical resources are relatively limited, strengthened coordination with hospitals in the neighboring city of Gwangju. The province also introduced a system that requests early assistance from the regional emergency coordination center when hospital selection is delayed.

The pilot also helped distribute patients more evenly across emergency facilities.

The average number of critically ill patients accepted daily by regional emergency medical centers rose from 35.6 in 2025 to 47.8 in May 2026. During the same period, the average number of patients with less severe conditions accepted by local emergency medical institutions increased from 79.1 to 86.8 per day.

The average daily number of deaths among critically ill patients fell from 8.3 in 2025 to 7.1 in May of this year.

The government cautioned against drawing broad conclusions from the results.

"The pilot lasted only three months, so it would be difficult to generalize the findings," said Lee Jung-kyu, director general for public health policy at the Health Ministry, during a media briefing on Friday. "However, objective data show that conditions have improved compared with before the pilot program."

The government plans to redesign transfer guidelines based on local medical resources, distances between hospitals and each region's capacity to provide follow-up treatment. Provincial governments are expected to submit draft revisions by July, followed by further adjustments in August ahead of implementation in September.

The government also sought to ease concerns raised by the medical community about the possibility of hospitals being forced to accept patients.

"There were no cases in which patients were sent to hospitals without prior contact and hospitals were simply told to accept them," Director General Lee added. “When no hospital could readily be found, we asked hospitals to accept the patient on a temporary basis, with the possibility of transferring the patient elsewhere later if needed.”

The Korean Society of Emergency Medicine also welcomed the pilot's results.

The society announced in a statement released on Friday that it "highly values" the government's plan to expand the program nationwide and to institutionalize feedback from frontline medical staff, including measures to reduce physicians' legal burden.

The society added that the pilot demonstrated that meaningful results could be achieved through "the private sector’s innovation, the public sector’s cooperation, along with respect for expert opinions and coordination among institutions."

Concerns remain, however, that delays could continue even after patients are admitted if hospitals lack the capacity to provide surgery, inpatient care, intensive care unit beds and other follow-up treatment.

Participants at the briefing on Sunday also identified several challenges that still need to be addressed, such as strengthening hospitals' capacity to provide follow-up care, revising guidelines for transferring patients across provincial boundaries, providing legal and institutional support for designated hospitals that agree to prioritize emergency patients and improving coordination and information-sharing among regional systems.

The government plans to evaluate the capacity of regional emergency medical centers to provide definitive treatment for severe emergencies as part of the redesignation process for emergency medical institutions. The government also aims to increase the number of regional emergency medical centers from the current 44 to as many as 60.

In addition, authorities plan to expand support for malpractice insurance premiums in essential medical fields to include neonatal and emergency medicine. Under the proposal, specialists would be eligible for liability coverage of up to 1.7 billion won ($1.1 million). Insurance premium subsidies would amount to approximately 1.75 million won per physician.

BY RHEE ESTHER [[email protected]]