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The impact of the COVID-19 associated shutdown on orthopedic patient care
Carola Hanreich1, Friedrich Boettner2, Scott DeNegre1
1Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA.
Insights
The COVID-19 pandemic shutdown significantly reduced orthopedic patient care and joint replacement surgeries. Telehealth appointments were vital for maintaining care, but volumes did not fully recover to pre-pandemic levels.
Area of Science:
- Orthopedic Surgery
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic led to the suspension of elective procedures, including joint replacement surgeries, in early March 2020.
- This study focuses on a specialized orthopedic hospital at the epicenter of the pandemic in the US.
Purpose of the Study:
- To analyze the impact of the COVID-19 shutdown on orthopedic patient care.
- To compare patient volumes and surgical procedures before and during the pandemic.
Main Methods:
- Comparative analysis of outpatient visits and joint replacement surgery volumes between 2019 and 2020.
- Correlation of patient volumes with governmental and institutional COVID-19 restrictions.
Main Results:
- Annual surgery volume decreased by 20.2% in 2020, with patient visits declining by 25.5%.
- Telehealth appointments surged to 28.5% in Q2 2020 but decreased to 7.6% by year-end.
- Patient care and surgery volumes recovered with declining SARS-CoV-2 cases but remained below pre-shutdown levels.
Conclusions:
- Orthopedic providers experienced significant disruptions in outpatient and surgical volumes due to the pandemic.
- Telemedicine played a crucial role in sustaining patient follow-up care and is expected to be important in the future.
- There was a notable shift towards utilizing satellite offices for patient appointments.
Background:
Due to the surge of COVID-19 cases in the US in early March 2020, health care facilities temporarily suspended elective and non-urgent medical procedures such as joint replacement surgeries. The aim of this study was to analyze the impact of the COVID-19 associated shutdown on orthopedic patient care at a specialized orthopedic hospital located at the epicenter of the COVID-19 pandemic.
Methods:
Patient volume of outpatient visits and joint replacement surgeries were analyzed and compared for 2019 and 2020. The volumes were further aligned with the timeline of governmental and institutional COVID-19 associated restrictions.
Results:
The annual surgery volume was reduced by 20.2% in 2020 and did not make up for the reduction experienced during the shutdown. The total number of patient visits decreased by 25.5% and new patient visits remained 25% lower at the end of 2020. Patient care and surgery volume recovered with declining SARS-CoV-2-cases but did not return to levels prior to the shutdown. During the second quarter of 2020, 28.5% of all patient visits were telehealth appointments. By the end of the year it dropped to 7.6%. There was a shift towards patient appointments at outpatient satellite offices.
Conclusion:
Orthopedic providers faced a substantial disruption in outpatient and surgical volume. Telemedicine appointments were crucial for maintaining follow-up patient care and will be an important sector in future patient care. There has been a major push to utilize satellite offices outside the city center.
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