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. 2021 Dec:268:389-393.
doi: 10.1016/j.jss.2021.07.013. Epub 2021 Jul 24.

The Impact of the COVID-19 Pandemic on Elective Inpatient Surgical Admissions: Evidence From Maryland

Joseph F Levy  1 , Kevin Y Wang  2 , Benedic N Ippolito  3 , James R Ficke  2 , Amit Jain  4
Affiliations

The Impact of the COVID-19 Pandemic on Elective Inpatient Surgical Admissions: Evidence From Maryland

Joseph F Levy et al. J Surg Res. 2021 Dec.

Abstract

Background: The COVID-19 pandemic led to large-scale cancellation and deferral of elective surgeries. We quantified volume declines, and subsequent recoveries, across all hospitals in Maryland.

Materials and methods: Data on elective inpatient surgical volumes were assembled from the Maryland Health Service Cost Review Commission for years 2019-2020. The data covered all hospitals in the state. We compared the volume of elective inpatient surgeries in the second (Q2) and fourth quarters (Q4) of 2020 to those same quarters in 2019. Analysis was stratified by patient, hospital, and service characteristics.

Results: Surgical volumes were 55.8% lower in 2020 Q2 than in 2019 Q2. Differences were largest for orthopedic surgeries (74.3% decline), those on Medicare (61.4%), and in urban hospitals (57.3%). By 2020 Q4, volumes for most service lines were within 15% of volumes in 2019 Q4. Orthopedic surgery remained most affected (44.5% below levels in 2019 Q4) and Plastic Surgery (21.9% lower).

Conclusions: COVID-19 led to large volume declines across hospitals in Maryland followed by a partial recovery. We observed large variability, particularly across service lines. These results can help contextualize case-specific experiences and inform research studying potential health effects of these delays and cancellations.

Keywords: COVID-19; Elective surgery; Pandemic; Surgical deferment.

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Conflict of interest statement

Disclosure None.

Figures

Fig 1
Fig. 1
Elective surgery admissions in Maryland, 2019-2020 Note: This figure shows total elective surgical volume from the first quarter of 2019 through the fourth quarter of 2020. Data are from the Maryland Health Service Cost Review Commission CaseMix System.
Fig 2
Fig. 2
Volume change in elective surgical admissions in Maryland, 2019-2020 Note: This figure shows elective surgical volume for selected high-volume service lines from the first quarter of 2019 through the fourth quarter of 2020. For ease of comparison, volume in each quarter is illustrated as a percent of volume for that service line in the fourth quarter of 2019. Data are from the Maryland Health Service Cost Review Commission CaseMix System.
See this image and copyright information in PMC

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