Resource utilization and outcomes in emergency general surgery during the COVID19 pandemic: an observational cost analysis
Autor/a
Trapero-Bertran, Marta
Borin, Alex
Butori, Eugenia
Curell, Anna
Souza, Arlena
Jensen, Joaquín
Turrado, Víctor
Morales, Xavier
Lacy, Antonio M
Fondevila, Constantino
Fecha de publicación
2021ISSN
1932-6203
Resumen
Background: Over the course of the COVID19 pandemic, global healthcare delivery has declined. Surgery is one of the most resource-intensive area of medicine; loss of surgical care has had untold health and economic consequences. Herein, we evaluate resource utilization, outcomes, and healthcare costs associated with unplanned surgery admissions during the height of the pandemic in 2020 versus the same period in 2019. Methods: Retrospective analysis on patients ≥18 years admitted from the emergency department to General & Digestive and Gastrointestinal Surgery Services between February and May 2019 and 2020 at our center; clinical outcomes and unadjusted and adjusted per-person healthcare costs were analyzed. Results: Consults and admissions to surgery declined between February and May 2020 by 37% and 19%, respectively, relative to the same period in 2019, with even greater relative decline during late March and early April. Time between onset of symptoms to diagnosis increased from 2±3 days 2019 to 5±22 days 2020 (P = 0.01). Overall hospital stay was two days less in 2020 (P = 0.19). Complications (Comprehensive Complication Index 10.3±23.7 2019 vs. 13.9±25.5 2020, P = 0.10) and mortality rates (3% vs. 4%, respectively, P = 0.58) did not vary. Mean unadjusted per-person costs for patients in the 2019 and 2020 cohorts were 5,886.72€±12,576.33€ and 5,287.62±7,220.16€, respectively (P = 0.43). Following multivariate analysis, costs remained similar (4,656.89€±390.53€ 2019 vs. 4,938.54±406.55€ 2020, P = 0.28). Conclusions: Healthcare delivery and spending for unplanned general surgery admissions declined considerably due to COVID19. These results provide a small yet relevant illustration of clinical and economic ramifications of this healthcare crisis.
Tipo de documento
Artículo
Versión del documento
Versión publicada
Lengua
English
Materias (CDU)
61 - Medicina
616.9 - Enfermedades infecciosas y contagiosas. Fiebres
Palabras clave
COVID-19 (malaltia)
Pandèmia
Atenció sanitària
Cirurgia
Atenció quirúrgica
COVID-19
Pandemia
Atención sanitaria
Cirugía
Atención quirúrgica
COVID-19
Pandemic
Health care
Surgery
Surgical care
Páginas
12
Publicado por
Public Library of Science
Colección
16; 6
Publicado en
PLoS One
Citación
Hessheimer, Amelia J.; Trapero-Bertran, Marta; Borin, Alex [et al.]. Resource utilization and outcomes in emergency general surgery during the COVID19 pandemic: an observational cost analysis. PLoS One, 2021, 16(6). Disponible en: <https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252919>. Fecha de acceso: 23 jun. 2021. DOI: 10.1371/journal.pone.0252919
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Derechos
© 2021 Hessheimer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Excepto si se señala otra cosa, la licencia del ítem se describe como https://creativecommons.org/licenses/by/4.0/