According to the results of two studies, postponing unnecessary surgery early in the coronavirus pandemic not only interrupted surgery in US hospitals, but also robbed most of the hospital’s total income. .. The results of these findings (from two studies conducted at the University of Pennsylvania, Philadelphia, and Philadelphia Children’s Hospital) were presented at the Virtual American College of Surgeons (ACS) Clinical Conference 2021.
Surgical services are usually an important financial engine for hospitals, and new research shows that reducing surgery can have serious implications even for two months. hospitalFinancial security. To conserve resources for patients with coronavirus disease (COVID-19) in 2019, the country’s most selective and non-urgent activities ceased from mid-March to early May 2020. According to one study, the two-month outage cost 42% of net income for five months to a single university’s healthcare system.
Nationally, hospitals lost $ 1.53 billion in selective pediatric surgery failures alone during about the same period from March to May 2020. Other researchers estimated the period from March to May 2020 as part of their research. Researchers estimated that the median or median time to recovery was one year.
Cases of COVID-19 reportedly remain high in many states, so some hospitals are triaging the cases again and delaying selected surgery.As a result, the researchers said their findings indicate the need for better long-term planning by hospitals to prevent further closures to ensure patient access. Surgical service What they need.
Reasons for not delaying surgical treatment
“It should not be delayed as much as possible Surgical treatment Daniel M. Mazzafero, MD, Ph.D. in Plastic Surgery, University of Pennsylvania, Perelman Medical College, said Daniel M. Mazzafero, Principal Investigator of the First Study. system. “
In addition, delays in surgical care can also exacerbate the patient’s condition, affect their quality of life, and sometimes lead to shortening it. Another result is that patients need more treatment and medical costs may rise in the future, says Dr. Mazzaferro.
This pandemic sets a precedent for many selective surgeries nationwide to free beds and other resources for COVID-19 patients, as recommended by the American Chemical Society (ACS) and other organizations in March 2020. It was a temporary postponement without. ACS provided guidance on how hospitals can triage surgical cases. That is, choose priority surgery and surgery to postpone until the number of COVID-19 cases decreases.Four
Dr. Mazzaferro and his colleagues compare the first surge of COVID-19 cases from March to July 2020, the net income of three hospitals in the “wave” healthcare system, compared to the same period in 2019. And calculated. In the first wave, more than $ 99 million in net revenue was lost from all surgical departments and $ 58 million from the surgical department. Using the latest data presented during the virtual clinical conference, the researchers reported a median net loss of $ 636,952 per department per month for the first wave of surgery. However, during the second COVID wave from October 1, 2020 to February 29, 2021, the system lost significantly less money, to $ 274,626 per month in each sector.
Dr. Liza Wu, MD, principal investigator of the study and professor of surgery at Perelman School of Medicine, said the surgery department did not interrupt selective surgery during the second surge.
“We were in a better position than in the beginning to continue the elective surgery,” said Dr. Wu. “We had more personal protective equipment or PPE, better COVID-19 therapy, and a better understanding of the virus, and we were probably able to discharge COVID patients sooner. . “
Their surgery department is also conducted by doctors at the University of Chicago Journal of American Universities of Surgeons.Five
Surgeons quickly regained productivity after selective surgery resumed in June 2020, Dr. Mazzaferro reported. He made this conclusion based on the surgeon’s productivity measure that the insurer uses for reimbursement. This is called the Working Relative Value Unit (RVU). Working RVU was significantly reduced in the second COVID-19 wave than in the first COVID-19 wave: 7.8% vs. 13.2%.
In the second study, researchers led by postdoctoral fellows at the Philadelphia Children’s Hospital, Sourav Bose, MD, MBA, and MSc, evaluated the economic impact of procedural cancellation of COVID-related children. To predict lost surgery revenue, they used the 2016 Kids’ Inpatient Database. This represents about 80% of pediatric hospitalizations nationwide.
Dr. Bose, a general surgeon at Brigham and Women’s Hospital in Boston, said the US pediatric hospital postponed or canceled an estimated more than 51,000 elective surgeries between March and May 2020.
“Our message isn’t just about revenue, it’s about how to effectively manage the needs of surgical patients,” said Dr. Bose. “Hospital systems need to evaluate operational management strategies to optimize the availability of surgical resources for patients with the greatest needs.”
He suggested that the hospital optimize the excess resource capacity that existed before the pandemic, or increase the capacity to perform resource-based procedures, such as increasing surgery time.
Dr. Mazzaferro also recommended that the healthcare system make long-term preparations to safely provide selective surgical treatment during future peaks in COVID-19 cases. He suggested the following:
- Increase hospital bed and resource capacity through alternative solutions such as sending surgical patient overflows to other patient care units or facilities that can accommodate them.
- Properly triage selective surgery according to ACS guidelinesFour And other published surgical triage tools.
- Ensure sufficient PPE for healthcare professionals and patients.
- Mandatory COVID-19 vaccine or frequent testing against the virus will help maintain staff health.
For more information:
Mazzaferro, DM, et al. Economic Impact of Covid-19 on the Surgical Sector: Impact of Surgical Shutdown and Impact on Healthcare Systems. American College of Surgeons Clinical Conference 2021.
American College of Surgeons
Quote: The hospital is a COVID-19 Pandemic (October 24, 2021) obtained from https://medicalxpress.com/news/2021-10-hospitals-sustained-huge-financial-losses.html on October 24, 2021. Incurred a huge financial loss from the income lost during the day)
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