Purpose: Korea’s treatment environment for patent ductus arteriosus (PDA) is challenged by specialized personnel shortages and increasing medicolegal risks. This study provides an empirical overview of surgical infrastructure and specialist availability across neonatal intensive care units nationwide to inform strengthening policies.Methods: We conducted a nationwide survey of 64 hospitals in the Korean Neonatal Network from April 3 to 14, 2026. Sixty centers responded (93.8%), covering staffing, surgical capacities, transfer barriers, and medicolegal experiences.Results: Pediatric cardiologists were available in 86.7% of institutions, while pediatric thoracic surgeons were available in only 56.7%, with a pronounced gap in the Gyeonggi/Incheon region (41.7%). In-hospital PDA ligation availability ranged from 68.2% in units 40 beds. Neonatologists performed 96.7% of emergency PDA echocardiography during off-hours, indicating a substantial workload. Primary barriers during out-transfer were clinical instability (54.4%) and lack of receiving hospitals (35.1%). Additionally, 15.5% of institutions reported medicolegal disputes related to PDA or neonatal surgery.Conclusion: Korea’s neonatal care system has reached a critical threshold in workforce shortages and medicolegal strain. There is an urgent need to establish regionally integrated care networks, provide substantial incentives for supporting specialties, and implement legal protections such as a special act for essential medical services. Policy should be redesigned to encompass workforce expansion, a stable supply of essential medications, and strategies to mitigate medicolegal risk.
Chung et al. (Sun,) studied this question.