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Differential Effects of the COVID-19 Pandemic on Surgical Utilization by Procedure Type: Analysis of Korean National
Shin-Woong Ko1, Byeong Jin Ha1, Yu Deok Won1
1Department of Neurosurgery, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 11923, Republic of Korea.
Insights
The COVID-19 pandemic impacted surgical utilization differently across surgery types and regions in Korea. While cataract and spine surgeries increased, joint replacements declined, highlighting the need for tailored strategies during health crises.
Area of Science:
- Health Services Research
- Surgical Outcomes
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted global healthcare services.
- The specific impact on surgical utilization, particularly across different surgery types and regions, requires detailed examination.
- Understanding these variations is crucial for maintaining essential surgical care during public health emergencies.
Purpose of the Study:
- To analyze trends in cataract, spine, and joint replacement surgeries in Korea from 2017-2021.
- To evaluate the pandemic's effect on surgical utilization based on surgery type, urgency, and care setting.
- To identify regional and institutional disparities in surgical access during the COVID-19 pandemic.
Main Methods:
- Utilized Korean National Health Insurance Service data (2017-2021).
- Analyzed trends across 17 regions and 8 healthcare institution categories.
- Employed interrupted time-series analysis to assess pandemic impact (2019-2021).
Main Results:
- Cataract (+4.8%) and spine (+5.0%) surgeries increased in 2020, while joint replacements decreased (-2.9%).
- Metropolitan areas demonstrated greater surgical utilization resilience compared to rural regions.
- Elective procedures saw an increase, whereas semi-urgent procedures declined, with variations observed across institutional types.
Conclusions:
- Surgical utilization patterns during the pandemic were diverse, influenced by surgery type, urgency, and regional factors.
- Findings underscore the need for context-specific policies to prioritize and sustain surgical services during health crises.
- Strategies are needed to ensure equitable access to essential surgical care across varied healthcare settings and geographic locations.
Abstract:
Objectives: The coronavirus disease 2019 (COVID-19) pandemic caused severe disruptions in healthcare services worldwide; however, its differential effects on surgical utilization have not been fully examined. This study aimed to analyze trends in three major surgery types-cataract, spine, and joint replacement-across regions and healthcare institutions in Korea and to evaluate how the pandemic affected surgical utilization according to surgery type, urgency, and care setting. Methods: The Korean National Health Insurance Service data collected from 2017 to 2021 were used to analyze trends in three major surgery typesacross 17 regions and eight categories of healthcare institutions in Korea. The effects of the pandemic were examined using an interrupted time-series analysis to compare annual growth rates and identify patterns during 2019-2021. Results: Our findings revealed distinct patterns based on the type of surgery. Cataract surgery (+4.8% compared with 2019) and spine surgery (+5.0%) continued to increase in 2020; however, the number of joint replacement surgeries decreased (-2.9%). Metropolitan areas showed greater resilience than rural regions, indicating regional disparities. At the institutional level, outpatient-focused clinics performed cataract surgeries, whereas hospital-based procedures showed variable trends. In addition, the differences correlated with surgical urgency: elective procedures continued to increase, whereas semi-urgent procedures decreased. Conclusions: during the pandemic, surgical utilization varied according to surgery type, urgency, and regional characteristics. These findings provide context-specific evidence for policymakers to prioritize surgical services during health crises and offer strategies to sustain essential surgical care across diverse healthcare settings and regions.
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