Impact of COVID 19 on the provision of surgical services in Ontario, Canada: population-based analysis

doi:10.1093/bjs/znaa043

. 2021 Jan 27;108(1):e15-e17.

doi: 10.1093/bjs/znaa043.

Impact of COVID 19 on the provision of surgical services in Ontario, Canada: population-based analysis

D Gomez^{1

2

3

4}, F Dossa^{1

5}, C Sue-Chue-Lam^{1

5}, A S Wilton⁴, C de Mestral^{1

3

4

5

6}, D Urbach^{1

4

5}, N Baxter^{3

4

5

7}

Affiliations

¹ Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Division of General Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
³ Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁴ ICES, Toronto, Ontario, Canada.
⁵ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁶ Division of Vascular Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁷ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 33640924
PMCID: PMC7799281
DOI: 10.1093/bjs/znaa043

Impact of COVID 19 on the provision of surgical services in Ontario, Canada: population-based analysis

D Gomez et al. Br J Surg. 2021.

. 2021 Jan 27;108(1):e15-e17.

doi: 10.1093/bjs/znaa043.

Authors

D Gomez^{1

2

3

4}, F Dossa^{1

5}, C Sue-Chue-Lam^{1

5}, A S Wilton⁴, C de Mestral^{1

3

4

5

6}, D Urbach^{1

4

5}, N Baxter^{3

4

5

7}

Affiliations

¹ Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Division of General Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
³ Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁴ ICES, Toronto, Ontario, Canada.
⁵ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁶ Division of Vascular Surgery, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁷ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 33640924
PMCID: PMC7799281
DOI: 10.1093/bjs/znaa043

Abstract

In this population-based analysis, the rate of surgical procedures decreased during the COVID period with hospitals rapidly reducing ambulatory and in-patient elective procedures in response to government directives. However, the observed and unexpected large reduction in urgent surgical procedures highlights the need to prioritize access to care for patients with emergency surgical conditions as part of pandemic planning.

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Figures

**Fig. 1**
Weekly rates of surgical procedures per 100 000 patient-weeks during 1 January to 31 March 31 in 2019 and 2020 a All surgical procedures; b ambulatory procedures; c elective inpatient procedures; d urgent procedures.

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Cited by

Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan.
Ibadin S, Brindle M, Wasylak T, Robert J, Litvinchuk S, Sauro KM. Ibadin S, et al. Int J Health Policy Manag. 2023;12:8007. doi: 10.34172/ijhpm.2023.8007. Epub 2023 Dec 10. Int J Health Policy Manag. 2023. PMID: 38618771 Free PMC article.
A Population-Based Analysis of Diabetes-Related Care Measures, Foot Complications, and Amputation During the COVID-19 Pandemic in Ontario, Canada.
de Mestral C, Gomez D, Wilton AS, Lee DS, Albalawi Z, Austin PC, Jacob-Brassard J, Urbach DR, Al-Omran M, Baxter NN. de Mestral C, et al. JAMA Netw Open. 2022 Jan 4;5(1):e2142354. doi: 10.1001/jamanetworkopen.2021.42354. JAMA Netw Open. 2022. PMID: 34985514 Free PMC article.
Impact of COVID-19 on scheduled lower extremity revascularization for chronic limb-threatening ischemia.
Erman A, Ramsay LC, Sander B, Haj-Ali W, Wu D, Setterfield M, Rahal M, Woodward G, Al-Omran M, de Mestral C. Erman A, et al. Br J Surg. 2021 Dec 17;109(1):e5-e7. doi: 10.1093/bjs/znab404. Br J Surg. 2021. PMID: 34878108 Free PMC article. No abstract available.
Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies.
Alzerwi NAN, Rayzah M, Alnemare AK, Elkhalifa AME. Alzerwi NAN, et al. Healthcare (Basel). 2023 Dec 31;12(1):96. doi: 10.3390/healthcare12010096. Healthcare (Basel). 2023. PMID: 38201002 Free PMC article.
Nimble Approach: fast, adapting, calculating and ethically mindful approach to managing colorectal cancer screening programmes during a pandemic.
Baxter NN, Facey M, Ruco A, Baker NA, Sorvari A, Benmessaoud A, Dube C, Rabeneck L, Tinmouth J. Baxter NN, et al. BMJ Open Gastroenterol. 2022 Jan;9(1):e000826. doi: 10.1136/bmjgast-2021-000826. BMJ Open Gastroenterol. 2022. PMID: 35046092 Free PMC article.

See all "Cited by" articles

References

1. Søreide K, Hallet J, Matthews JB. et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg 2020; DOI:10.1002/bjs.11670 [Epub ahead of print] - PMC - PubMed
1. Williams DC. COVID-19 Directive #2 for Health Care Providers (Regulated Health Professionals or Persons Who Operate a Group Practice of Regulated Health Professionals). https://www.coto.org/docs/default-source/covid-19/directive-2-may-26-202... (accessed 1 September 2020).
1. Ministry of Health. Ramping Down Elective Surgeries and Other Non-Emergent Activities.https://www.oha.com/Bulletins/DM OH CMOH memo COVID19 elective surgery (2020-03-15).pdf (accessed 23 March 2020)
1. Canadian Institute for Health Information. CCI: A Guide to Intervention Code Assignment https://www.cihi.ca/sites/default/files/document/cci-guide-en.pdf (accessed 7 August 2020)
1. Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung SH et al.The Covid-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med 2020;383:691–693 - PubMed

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[1] Søreide K, Hallet J, Matthews JB. et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg 2020; DOI:10.1002/bjs.11670 [Epub ahead of print] - PMC - PubMed

[2] Søreide K, Hallet J, Matthews JB. et al. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg 2020; DOI:10.1002/bjs.11670 [Epub ahead of print] - PMC - PubMed

[3] Williams DC. COVID-19 Directive #2 for Health Care Providers (Regulated Health Professionals or Persons Who Operate a Group Practice of Regulated Health Professionals). https://www.coto.org/docs/default-source/covid-19/directive-2-may-26-202... (accessed 1 September 2020).

[4] Williams DC. COVID-19 Directive #2 for Health Care Providers (Regulated Health Professionals or Persons Who Operate a Group Practice of Regulated Health Professionals). https://www.coto.org/docs/default-source/covid-19/directive-2-may-26-202... (accessed 1 September 2020).

[5] Ministry of Health. Ramping Down Elective Surgeries and Other Non-Emergent Activities.https://www.oha.com/Bulletins/DM OH CMOH memo COVID19 elective surgery (2020-03-15).pdf (accessed 23 March 2020)

[6] Ministry of Health. Ramping Down Elective Surgeries and Other Non-Emergent Activities.https://www.oha.com/Bulletins/DM OH CMOH memo COVID19 elective surgery (2020-03-15).pdf (accessed 23 March 2020)

[7] Canadian Institute for Health Information. CCI: A Guide to Intervention Code Assignment https://www.cihi.ca/sites/default/files/document/cci-guide-en.pdf (accessed 7 August 2020)

[8] Canadian Institute for Health Information. CCI: A Guide to Intervention Code Assignment https://www.cihi.ca/sites/default/files/document/cci-guide-en.pdf (accessed 7 August 2020)

[9] Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung SH et al.The Covid-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med 2020;383:691–693 - PubMed

[10] Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung SH et al.The Covid-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med 2020;383:691–693 - PubMed

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Impact of COVID 19 on the provision of surgical services in Ontario, Canada: population-based analysis

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Impact of COVID 19 on the provision of surgical services in Ontario, Canada: population-based analysis

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