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Impact of COVID-19 Pandemic on Performance of Gastrointestinal Endoscopy
Youn Kyung Kim1, Su Bee Park1, Moonhyung Lee1
1Department of Gastroenterology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea.
Insights
The COVID-19 pandemic reduced gastrointestinal endoscopy procedures like EGD and colonoscopy. However, ERCP and abdominal US claims saw smaller declines, with ERCPs being more time-sensitive and US procedures non-aerosolized.
Area of Science:
- Gastroenterology
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic led to deferral of non-urgent gastrointestinal endoscopy due to infection risk.
- No prior population-based studies quantified the pandemic's impact on gastrointestinal procedures.
Purpose of the Study:
- To examine the impact of the COVID-19 pandemic on the performance of key gastrointestinal procedures in South Korea.
- Specifically analyze changes in esophagogastroduodenoscopy (EGD), colonoscopy, ERCP, and abdominal ultrasonography (US) during the pandemic.
Main Methods:
- A nationwide, population-based study design was employed.
- Compared healthcare claim data for EGD, colonoscopy, ERCP, and abdominal US in 2020-2021 (COVID-19 era) against 2019 (pre-pandemic baseline).
Main Results:
- Annual claims for EGD and colonoscopy decreased by 6.3% and 6.9% in 2020, respectively.
- ERCP and abdominal US claims increased by 1.0% and 2.9% in 2020.
- During the March-April 2020 surge, monthly claims for EGD, colonoscopy, ERCP, and US dropped by 28.8%, 43.8%, 5.1%, and 21.6% respectively in March, and 17.2%, 32.8%, 4.4%, and 9.5% in April, compared to 2019.
Conclusions:
- Gastrointestinal endoscopy (EGD, colonoscopy) claims significantly decreased during the COVID-19 pandemic.
- ERCP and abdominal US claims showed less significant reductions.
- ERCP's time-sensitive nature and US's non-aerosolized characteristics likely contributed to their smaller declines.
Background/Aims:
Non-time-sensitive gastrointestinal endoscopy was deferred because of the risk of exposure to coronavirus disease 2019 (COVID-19), but no population-based studies have quantified the adverse impact on gastrointestinal procedures. This study examined the impact of the COVID-19 pandemic on the performance of esophagogastroduodenoscopy (EGD), colonoscopy, ERCP, and abdominal ultrasonography (US) in South Korea.
Methods:
This nationwide, population-based study compared the claim data of EGD, colonoscopy, ERCP, and abdominal US in 2020 and 2021 (COVID-19 era) with those in 2019 (before the COVID-19 era).
Results:
During the first year (2020) of the COVID-19 pandemic, the annual claim data of EGD and colonoscopy were reduced by 6.3% and 6.9%, respectively, but those of ERCP and abdominal US were increased by 1.0% and 2.9%, compared to those in 2019. During the first surge (March and April 2020) of COVID-19, the monthly claim data of EGD, colonoscopy, ERCP, and abdominal US were reduced by 28.8%, 43.8%, 5.1%, and 21.6%, respectively, in March 2020, and also reduced by 17.2%, 32.8%, 4.4%, and 9.5%, respectively, in April 2020, compared to those in March and April 2019. During March and April 2020, the monthly claims of ERCP, compared with those in 2019, declined less significantly than those of EGD and colonoscopy (both p<0.001).
Conclusions:
The claims of EGD and colonoscopy were reduced more significantly than those of ERCP and abdominal US during the COVID-19 pandemic because ERCPs are time-sensitive procedures and abdominal USs are non-aerosolized procedures.
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