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Impact of the COVID-19 Pandemic on Elective and Emergency Inpatient Procedure Volumes in Switzerland - A
Yael Rachamin1, Matthias R Meyer2,1, Thomas Rosemann1
1Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Insights
The COVID-19 pandemic significantly reduced inpatient procedures in Switzerland, with elective surgeries seeing a 52.9% drop in spring 2020. While volumes recovered, a yearly deficit remained, highlighting the need for maintaining non-COVID-19 care access.
Area of Science:
- Healthcare Management
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic necessitated resource reallocation in hospitals, impacting non-emergency care.
- The precise effect of the pandemic on elective and emergency inpatient procedure volumes remained unclear.
Purpose of the Study:
- To quantify the impact of the COVID-19 pandemic on inpatient procedure volumes in Switzerland.
- To assess the recovery and compensation effects on elective and emergency procedures throughout 2020.
Main Methods:
- Analysis of anonymized hospitalization data from a Swiss health insurer (2017-2020).
- Utilized linear regression models to predict expected procedure volumes in 2020 absent the pandemic.
- Compared predicted volumes with observed data to determine pandemic-related changes and compensation effects.
Main Results:
- Elective procedure volumes dropped by 52.9% during the first COVID-19 wave, with cardiovascular and orthopedic procedures significantly affected.
- Post-wave recovery was observed, but a net deficit of -9.9% in elective procedures persisted for the year 2020.
- Emergency procedure volumes decreased initially but returned to baseline levels by year-end, showing minimal net change.
Conclusions:
- Inpatient procedure volumes in Switzerland experienced a sharp decline and subsequent recovery post-first COVID-19 wave.
- A net deficit in procedures occurred by the end of 2020, underscoring the need for robust strategies to maintain non-COVID-19 care during health crises.
- Ensuring continued access to essential medical procedures is crucial to prevent adverse health outcomes during future pandemic phases.
Background:
The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic forced hospitals to redistribute resources for the treatment of patients with coronavirus disease 2019 (COVID-19), yet the impact on elective and emergency inpatient procedure volumes is unclear.
Methods:
We analyzed anonymized data on 234 921 hospitalizations in 2017-2020 (55.9% elective) from a big Swiss health insurer. We used linear regression models to predict, based on pre-pandemic data, the expected weekly numbers of procedures in 2020 in the absence of a pandemic and compared these to the observed numbers in 2020. Compensation effects were investigated by discretely integrating the difference between the two numbers over time.
Results:
During the first COVID-19 wave in spring 2020, elective procedure numbers decreased by 52.9% (95% confidence interval -64.5% to -42.5%), with cardiovascular and orthopedic elective procedure numbers specifically decreasing by 45.5% and 72.4%. Elective procedure numbers normalized during summer with some compensation of postponed procedures, leaving a deficit of -9.9% (-15.8% to -4.5%) for the whole year 2020. Emergency procedure numbers also decreased by 17.1% (-23.7% to -9.8%) during the first wave, but over the whole year 2020, net emergency procedure volumes were similar to control years.
Conclusion:
Inpatient procedure volumes in Switzerland decreased considerably in the beginning of the pandemic but recovered quickly after the first wave. Still, there was a net deficit in procedures at the end of the year. Health system leaders must work to ensure that adequate access to non-COVID-19 related care is maintained during future pandemic phases in order to prevent negative health consequences.
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