Health impact of the Serious Accidents Punishment Act in Korean occupational settings

Abstract Background Interrupted time series analysis serves as a valuable study design for assessing the efficacy of public health interventions implemented at a specific moment in time at the population level. We aim to elucidate the effects of the Serious Accidents Punishment Act implemented in February 2021 in Korea by analyzing changes in the incidence rates of occupational diseases. Methods The monthly data from patients with occupational diseases was extracted from the National Health Insurance Service Cohort database from 2011 to 2023. An Interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after the Serious Accidents Punishment Act introduction in both outpatients and inpatients. Adjustments or stratification variables included sex, age, company size, and injury-related international classification of diseases codes (Injury, poisoning, and certain other consequences of external causes, S00-T88). Results Based on injury rates, men’s inpatient injury rates remained stable, but outpatient rates decreased after the act implementation, while women’s injury rates consistently declined in both inpatient and outpatient settings. The Interrupted time series regression analysis indicates that the Serious Accidents Punishment Act led to a significant reduction in both outpatient and inpatient injury rates for men and women, with a marked decline in outpatient rates and hospital admissions among women post-intervention. Conclusions The Interrupted time series regression results suggest that the Serious Accidents Punishment Act has been effective in reducing injury-related healthcare usage, highlighting the necessity of gender-specific interventions and the potential impact on lowering inpatient visits, although causality remains uncertain without further analysis. Key messages • The Serious Accidents Punishment Act significantly reduced occupational injury rates in Korea, especially among women, demonstrating effective public health intervention. • Interrupted time series analysis reveals Serious Accidents Punishment Act’s impact on reducing healthcare usage for occupational injuries, highlighting the need for gender-specific approaches.