Effects of Covid-19 on the elective surgery: an approach based on the case of the Italian Province of Bolzano

BACKGROUND: As of February 2020, the rise of COVID-19 cases led to significant pressures in the Northern parts of Italy, including the province of Bolzano (a small territorial reality on the border between Italy and Austria), and left the Italian National Health System (NHS) unprepared for the initial wave of the SARS-CoV-2 pandemic. OBJECTIVE/METHODS: By dividing the analyses into two phases, the study assesses the effect of COVID-19 for the years 2018–2019 and 2020–2021. The first phase highlights the hospitalization rates in the Province of Bolzano in comparison to other Italian regions. In the second step, the Systematic Component of Variation (SCV) has been applied to calculate the differences between the admission rates for the elective surgery (tonsillectomy, vein stripping, hip replacement, knee replacement, and arthroscopy) in the four health districts (HDs) of the Province of Bolzano. RESULTS: Overall, the findings demonstrate that the effect of COVID-19 cases has resulted in a 20% reduction in hospitalization rates. A variation of less than 30% for knee and hip replacements and up to 75% for vein stripping is seen for elective surgeries. According to the SCV values for each elective procedure, the results indicate comparable levels of variation across the two time periods, with tonsillectomy showing the lowest levels of variation, arthroscopy and vein stripping having the highest levels, hip replacement having a high level and knee replacement having a low-medium level. CONCLUSIONS: The data show no significant changes in the variation between the four HDs in the province of Bolzano, suggesting that the COVID-19 cases have a proportionate impact on hospitalization rates.