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. 2020 Nov;44(11):2221-2228.
doi: 10.1007/s00264-020-04713-8. Epub 2020 Jul 17.

Economic implications of decreased elective orthopaedic and musculoskeletal surgery volume during the coronavirus disease 2019 pandemic

Matthew J Best  1 , Keith T Aziz  2 , Edward G McFarland  2 , Gerard F Anderson  3 , Uma Srikumaran  2
Affiliations

Economic implications of decreased elective orthopaedic and musculoskeletal surgery volume during the coronavirus disease 2019 pandemic

Matthew J Best et al. Int Orthop. 2020 Nov.

Abstract

Purpose: In order to reduce viral spread, elective surgery was cancelled in most US hospitals for an extended period during the COVID-19 pandemic. The purpose of this study was to estimate national hospital reimbursement and net income losses due to elective orthopaedic surgery cancellation during the COVID-19 pandemic.

Methods: The National Inpatient Sample (NIS) and the Nationwide Ambulatory Surgery Sample (NASS) were used to identify all elective orthopaedic and musculoskeletal (MSK) surgery performed in the inpatient setting and in hospital owned outpatient surgery departments throughout the USA. Total cost, reimbursement, and net income were estimated for all elective orthopaedic surgery and were compared with elective operations from other specialties.

Results: Elective MSK surgery accounted for $65.6-$71.1 billion in reimbursement and $15.6-$21.1 billion in net income per year to the US hospital system, equivalent to $5.5-$5.9 billion in reimbursement and $1.3-$1.8 billion in net income per month. When compared with elective surgery from all other specialties, elective MSK surgery accounted for 39% of hospital reimbursement and 35% of hospital net income. Compared with all hospital encounters for all specialties, elective MSK surgery accounted for 13% of reimbursement and 23% of net income. Estimated hospital losses from cancellation of elective MSK surgery during 8 weeks of the COVID-19 pandemic were $10.9-$11.9 billion in reimbursement and $2.6-3.5 billion in net income.

Conclusion: Cancellation of elective MSK surgery for 8 weeks during the COVID-19 pandemic has substantial economic implications on the US hospital system.

Keywords: COVID-19; Economic impact; Elective surgery cancellation; Orthopaedic surgery.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Percentages of national hospital aggregate cost, reimbursement, and net income per year comparing elective orthopedic and musculoskeletal surgery to elective surgery in all other specialties in the USA. Elective MSK, elective orthopaedic and musculoskeletal surgery
Fig. 2
Fig. 2
Percentages of national hospital aggregate cost, reimbursement, and net income per year comparing elective orthopaedic and musculoskeletal surgery to all other encounters (elective and non-elective, inpatient and outpatient, surgical and non-operative) in the USA. Elective MSK, elective orthopaedic and musculoskeletal surgery
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References

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