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The Effect of COVID-19 on Cardiac Surgical Volume and its Associated Costs
Edgar Aranda-Michel1, Derek Serna-Gallegos2, George Arnaoutakis3
1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Insights
The COVID-19 pandemic caused a 28.3% decrease in cardiac surgery volume, resulting in over $2.5 billion in lost hospital revenue. This study quantifies the financial impact of reduced cardiac surgical procedures during the pandemic.
Area of Science:
- Cardiovascular Surgery
- Health Economics
- Pandemic Impact on Healthcare
Background:
- The COVID-19 pandemic disrupted healthcare systems globally, significantly impacting surgical volumes.
- Limited data exists on the financial repercussions of decreased cardiac surgical procedures during the pandemic.
Purpose of the Study:
- To estimate the national impact of the COVID-19 pandemic on cardiac surgical volume.
- To quantify the associated hospital revenue loss.
- To analyze patient demographics and procedure types during the pandemic.
Main Methods:
- Utilized the National Inpatient Sample database and single-center data for volume estimation.
- Employed hospital charges and charge-to-cost ratios to calculate lost revenue.
- Applied a Gompertz function to model volume recovery and compared 2019 vs. 2020 demographics.
Main Results:
- A maximum decrease of 28.3% in cardiac surgical volume was observed.
- Estimated cumulative loss of over 35,000 cases and $2.5 billion in hospital revenue.
- Patients undergoing surgery during the pandemic were younger, more likely to have CABG, and had longer hospital stays.
Conclusions:
- The pandemic led to a substantial reduction in cardiac surgical volume and significant hospital revenue loss.
- Findings highlight the need to address surgical backlogs and prepare for future public health crises.
- Data can inform programmatic adjustments for healthcare resilience.
Abstract:
The COVID-19 pandemic significantly affected health care and in particular surgical volume. However, no data surrounding lost hospital revenue due to decreased cardiac surgical volume have been reported. The National Inpatient Sample database was used with decreases in cardiac surgery at a single center to generate a national estimate of decreased cardiac operative volume. Hospital charges and provided charge to cost ratios were used to create estimates of lost hospital revenue, adjusted for 2020 dollars. The COVID period was defined as January to May of 2020. A Gompertz function was used to model cardiac volume growth to pre-COVID levels. Single center cardiac case demographics were internally compared during January to May for 2019 and 2020 to create an estimate of volume reduction due to COVID. The maximum decrease in cardiac surgical volume was 28.3%. Cumulative case volume and hospital revenue loss during the COVID months as well as the recovery period totaled over 35 thousand cases and 2.5 billion dollars. Institutionally, patients during COVID months were younger, more frequently undergoing a CABG procedure, and had a longer length of stay. The pandemic caused a significant decrease in cardiac surgical volume and a subsequent decrease in hospital revenue. This data can be used to address the accumulated surgical backlog and programmatic changes for future occurrences.
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