Impact of the 2024 Resident Physician Work Stoppage on Acute Hemorrhagic Stroke Admissions: A Single Cerebrovascular-Specialty Hospital Study in South Korea

<b>Background</b>: In February 2024, a nationwide resignation of resident physicians and fellows in South Korea caused a sudden disruption in the healthcare service delivery system. This study aimed to investigate how the crisis affected hospital admission patterns, treatment timelines, and early outcomes in patients with acute hemorrhagic stroke. <b>Methods</b>: We retrospectively analyzed data from prospective cohorts of patients diagnosed with intracerebral hemorrhage or subarachnoid hemorrhage admitted to a single cerebrovascular-specialty hospital between March 2023 and February 2025. Patients were categorized into two groups: those admitted before (Before crisis group, <i>n</i> = 130) and after (After crisis group, <i>n</i> = 214) the crisis. Clinical characteristics, regional distribution, time delays, and 3-month modified Rankin Scale (mRS) outcomes were compared. <b>Results</b>: Following the crisis, a significant increase was observed in admissions from outside the hospital's primary coverage area (<i>p</i> < 0.001). Onset-to-arrival (138.0 vs. 92.0 min, <i>p</i> = 0.040) and onset-to-operation times (200.0 vs. 166.0 min, <i>p</i> = 0.046) were significantly delayed, particularly in patients who underwent surgical treatment. However, arrival-to-operation time remained stable (<i>p</i> = 0.694), and initial neurological severity was comparable. Functional outcomes at 3 months did not differ significantly (mRS 0-2: 53.8% vs. 50.5%, <i>p</i> = 0.157), indicating preserved in-hospital care quality, despite external disruption. <b>Conclusions</b>: The medical crisis disrupted the stroke care delivery system and delayed prehospital care in South Korea. Nevertheless, the cerebrovascular-specialty hospital maintained timely intervention and preserved outcomes. These findings support the strategic importance of decentralized specialty hospitals in ensuring the resilience of the healthcare service delivery system during a national healthcare crisis.