Organization and delivery of medical services at the 19th Asian Games in Hangzhou China

As the first Asian Games held after the COVID-19 pandemic, this study evaluates the dual challenges of managing routine sports injuries and illnesses alongside pandemic-specific protocols, including intelligent disease surveillance and hybrid medical systems. The transition from closed-loop to open events necessitated a novel approach to medical service planning, integrating real-time health monitoring and adaptive public health strategies. This study aimed to evaluate the effectiveness of medical services at the 19th Asian Games by analyzing injury/illness rates and emergency response efficiency. It also assessed the impact of post-pandemic protocols, such as hybrid healthcare systems and self-rehabilitation strategies for mild COVID-19 cases, on care delivery. The findings offer actionable insights to optimize medical resource allocation in future multisport events, ensuring preparedness for both routine healthcare demands and pandemic-related challenges. Medical services were provided for 33 days to all Games stakeholders. The Games introduced an integrated medical information system-Emergency Medical Support System (EMSS) and Asian Games Information System-Medical Department (AGIS-MED)-to enable real-time data sharing, standardized injury classification, and efficient emergency transfers. This cross-sectional study analyzed illness and injury patterns, medication usage, and the efficiency of medical response protocols during the 19th Asian Games (September 23-October 8, 2023). A total of 11,658 medical encounters were recorded, including 2368 injuries and 9290 illnesses. Among the 1870 athlete cases, 40.7% were injuries and 59.2% were illnesses, with an overall injury rate of 6.44 per 100 registered athletes. Contact sports such as wrestling, basketball, boxing, hockey, and athletics exhibited the highest injury rates. Emergency transfers were required in 349 cases, and 54 patients were hospitalized. Despite relaxed COVID-19 testing mandates, the Games reported zero outbreaks, demonstrating the effectiveness of self-rehabilitation strategies for mild cases. The integration of intelligent medical systems and dynamic medical resource allocation significantly enhanced emergency response efficiency. Our data-driven framework, including segregated hospital wards and optimized personnel distribution, reduced athlete hospitalization stays to 3 days (vs. the national average of 9.2 days), offering a replicable model for future large-scale sports events.