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[Influence of COVID-19 shutdown on the workload of a university eye clinic]
C Framme1, J Gottschling2, P Buley1
1Universitäts-Augenklinik, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30652, Hannover, Deutschland.
Insights
The COVID-19 pandemic significantly reduced university policlinic patient contacts by 59.5%, leading to substantial financial losses. Patient attendance time also decreased, impacting overall clinic performance during the shutdown.
Area of Science:
- Ophthalmology
- Health Economics
- Public Health
Background:
- The COVID-19 pandemic caused a significant decline in elective medical treatments in hospitals during spring 2020.
- Data on the impact of the pandemic on university policlinics were previously unavailable.
Purpose of the Study:
- To evaluate the impact of the COVID-19 shutdown on patient contacts and financial performance at a university policlinic.
- To compare patient contact data and revenue during the COVID-19 shutdown period with the previous year.
Main Methods:
- Utilized electronic medical record system (IS-H/i.s.h.med) and time recording software (TimeElement) to analyze patient contacts over a 7-week period in 2020.
- Compared 2020 data with the same period in 2019 and analyzed quarterly revenues using SAP.
Main Results:
- Total patient contacts decreased by 59.5%, with a 74.8% reduction in lockdown period cases compared to 2019.
- University outpatient/self-paying sectors saw the largest drop (to 17.2% of baseline), resulting in at least €218,000 in financial losses.
- Special diagnostic services decreased by 69.4%, including a 75.3% reduction in visual field examinations and a 60.3% decrease in OCT measurements. Average patient attendance time reduced by 23%.
Conclusions:
- The COVID-19 shutdown reduced policlinic work performance to approximately 40% of patient contacts and 30% of functional diagnostic examinations compared to 2019.
- Reduced patient numbers led to shorter clinic visit durations.
- The financial losses incurred were substantial and not fully compensated by existing payment structures.
Background:
The outbreak of the novel coronavirus disease 2019 (COVID-19) has led to a significant reduction in the number of patients treated in elective medicine in hospitals in spring 2020. Up until now, there are no corresponding data for university policlinics.
Material And Methods:
With the help of the data of the clinic's electronic medical record system (IS-H/i.s.h.med from SAP, Cerner Corporation, North Kansas City, MO, United States of America and SAP SE, Walldorf, Germany) and the time recording and management software TimeElement (Hannover Medical School, Hannover, Germany), which was codeveloped at our clinic, all patient contacts of the COVID-19 shutdown were evaluated over a period of approximately 7 weeks from 18 March 2020 to 8 May 2020 and compared with the same period in 2019. In addition, quarterly revenues for the first and second quarters of 2019 and 2020 were put into perspective via SAP.
Results:
During the COVID-19 period the total number of patient contacts was reduced by 59.5% compared to the previous year. The number of lockdown period cases decreased by 74.8% compared to the same period in 2019. In particular, the university outpatient/self-paying sector recorded the largest number of lost patient contacts with a reduction to 17.2% of the 2019 baseline. The reduced patient contacts and case numbers resulted in a significant financial loss of at least € 218,000. Via TimeElement there was a 69.4% decrease in all special diagnostic services, with visual field examinations in particular also reduced by 75.3%. Optical coherence tomography (OCT) measurements recorded a decrease of 60.3%. Patient tracking revealed a reduction of average patient attendance times by approximately 23% (COVID 19: 145.8 ± 88.8 min versus 189.6 ± 97.2 min in 2019).
Discussion:
The COVID-19 shutdown caused the work performance of our policlinic to drop to only about 40% of patient contacts and that of functional diagnostic examinations to only about 30%, compared to the performance in 2019; however, the reduction in the number of patients also led to a significant reduction in the time patients were present at the clinic compared to the regular workload. The associated financial losses are considerable and obviously not compensated by legally regulated compensation payments as in the inpatient sector.
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