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Resource requirements for reintroducing elective surgery during the COVID-19 pandemic: modelling study
A J Fowler1, T D Dobbs2,3, Y I Wan1
1William Harvey Research Institute, Queen Mary University of London, London, UK.
Insights
The COVID-19 pandemic caused significant surgical procedure cancellations, impacting millions of patients and incurring billions in costs. Reintroducing elective surgery requires substantial resources to address the growing surgical backlog.
Area of Science:
- Health Economics
- Surgical Outcomes
- Public Health Policy
Background:
- The COVID-19 pandemic necessitated the suspension of non-urgent surgical procedures.
- This led to a substantial backlog of elective surgeries and impacted healthcare systems globally.
Purpose of the Study:
- To model the number of surgical procedures cancelled due to COVID-19.
- To estimate the deficit in surgical procedures and the associated costs.
- To project the resources needed for the gradual reintroduction of elective surgery.
Main Methods:
- A modeling study utilizing Hospital Episode Statistics data from 2014-2019.
- Surgical procedures were categorized into four urgency classes.
- Estimates were generated for expected procedures, deficits, and costs, with gradual reintroduction of elective surgery from June 2020.
Main Results:
- An estimated 749,247 surgical procedures were cancelled by May 31, 2020.
- By February 28, 2021, approximately 2.3 million patients were projected to be awaiting surgery.
- The cost of delayed procedures was estimated at €5.3 billion, with an additional €526.8 million needed for safe surgical delivery.
Conclusions:
- The COVID-19 pandemic has significantly delayed elective surgery provision.
- These delays are associated with increased healthcare costs and a substantial surgical backlog.
- Addressing the backlog requires significant additional resources and strategic planning for surgical recovery.
Background:
The COVID-19 response required the cancellation of all but the most urgent surgical procedures. The number of cancelled surgical procedures owing to Covid-19, and the reintroduction of surgical acivirt, was modelled.
Methods:
This was a modelling study using Hospital Episode Statistics data (2014-2019). Surgical procedures were grouped into four urgency classes. Expected numbers of surgical procedures performed between 1 March 2020 and 28 February 2021 were modelled. Procedure deficit was estimated using conservative assumptions and the gradual reintroduction of elective surgery from the 1 June 2020. Costs were calculated using NHS reference costs and are reported as millions or billions of euros. Estimates are reported with 95 per cent confidence intervals.
Results:
A total of 4 547 534 (95 per cent c.i. 3 318 195 to 6 250 771) patients with a pooled mean age of 53.5 years were expected to undergo surgery between 1 March 2020 and 28 February 2021. By 31 May 2020, 749 247 (513 564 to 1 077 448) surgical procedures had been cancelled. Assuming that elective surgery is reintroduced gradually, 2 328 193 (1 483 834 - 3 450 043) patients will be awaiting surgery by 28 February 2021. The cost of delayed procedures is €5.3 (3.1 to 8.0) billion. Safe delivery of surgery during the pandemic will require substantial extra resources costing €526.8 (449.3 to 633.9) million.
Conclusion:
As a consequence of the Covid-19 pandemic, provision of elective surgery will be delayed and associated with increased healthcare costs.
