Changes in Procedural Volume and Patient Presentation for Key Inpatient Surgeries: A Comparison of the PRE- VS Peri-COVID-19 Era.
Author(s)
ABSTRACT WITHDRAWN
OBJECTIVES: As COVID-19 infection cases have increased in the United States, many local governments requested hospitals to postpone elective procedures for resources to be made available to affected patients. It has also been hypothesized that many patients with urgent conditions other than COVID-19 have forgone medical care to stay away from hospitals. This study was designed to assess the reduction in key elective procedures and changes in patient presentation. METHODS: This is a retrospective data analysis using the Premier Healthcare Database from 2018-2020. The top 10 procedure categories based on frequency in 2018-2019 were identified. For each procedure category, relative volume changes from Jan-June 2019 (pre-covid-era) to Jan-June 2020 (peri-covid-era), and patient presentation (demographics, Elixhauser comorbidity (score and 31 domains) and payer mix) were analyzed and compared between the pre- and peri-covid-era. All findings were described using descriptive statistics, differences assessed by Standard t-test (p> 0.05). RESULTS: Top procedures identified in 2019 included obstetric care (normal delivery and C-section), cardiac procedures (heart and vessel surgery (HVS), cardiac catheterization (CC), heart fluoroscopy (HF)), gastrointestinal system excisions (GIE) and lower joint replacements (LJR). When normalized to 2019, the largest decline in procedure volume was observed for LJR (45%), GIE (8%), HF (8%) and CC (6%). Average Elixhauser index was significantly higher during the peri-covid-era vs pre-covid-era for the following procedures: LJR: 2.47 (SD: 1.77) vs 2.26 (SD: 1.66); HVS: 5.03 (SD: 2.61) vs 4.82 (SD: 2.56); CC: 4.22 (SD: 2.47) vs 4.03 (SD:2.38); GIE: 3.95 (SD:2.44) vs 3.72 (SD:2.36); HF: 4.21 (SD 2.32) vs 4.06 (SD: 2.27) – p< 0.001 in all cases). CONCLUSIONS: The SARS-CoV-2 pandemic resulted in significant, planned reduction of elective procedures. Cardiovascular and joint procedures were mostly affected, and when treated, patients had overall greater comorbidities. Ongoing research would include understanding long-term outcomes of patients treated during the pandemic.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PMU19
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Clinical Outcomes Assessment
Disease
Multiple Diseases