Effect of natural disaster on routine surgery

Area of Science:

• Surgical Outcomes Research
• Disaster Medicine Impact Analysis
• Healthcare Economics

Background:

• Assessing the impact of Hurricane Katrina on surgical procedures.
• Utilizing laparoscopic cholecystectomy (LC) as an index case for analysis.

Purpose of the Study:

• To evaluate the effects of Hurricane Katrina on routine surgical operations.
• To analyze changes in operative time, length of stay, cost, revenue, staffing, and payer mix post-disaster.

Main Methods:

• Comparative analysis of laparoscopic cholecystectomy (LC) cases (inpatient and outpatient) in the 7 months before and 7 months after Hurricane Katrina.
• Data collection included operative time, length of stay, turnover time, cost, revenue, staff levels, and payer mix.
• Analysis commenced 3 months post-storm to ensure stabilized operating room volumes.

Main Results:

• No significant changes in operative time, length of stay, or turnover time were observed despite staffing challenges.
• Post-storm, costs decreased for both inpatient and outpatient LC, primarily due to reduced staff levels.
• Revenue declined for inpatient LC, while outpatient LC revenue saw a slight increase. Payer mix shifted towards a higher proportion of Medicare, Medicaid, and uninsured patients.

Conclusions:

• Hurricane Katrina led to cost efficiencies in laparoscopic cholecystectomy (LC) but reduced overall revenue due to increased uninsured patient volume.
• Surgical efficiency remained stable despite significant staff turnover and loss.
• Healthcare facilities must prepare for disaster-related staff turnover, increased uninsured patient populations, and potential decreases in outpatient surgical volumes.