Cargando…

The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice

PURPOSE: The impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) has been felt worldwide. We examined the quantitative impact during the first 4 weeks of hospital system and state-mandated restrictions on an academic, urban hand surgery practice. We hypothesized...

Descripción completa

Detalles Bibliográficos
Autores principales: Earp, Brandon E., Zhang, Dafang, Benavent, Kyra A., Byrne, Laura, Blazar, Philip E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590933/
https://www.ncbi.nlm.nih.gov/pubmed/34805806
http://dx.doi.org/10.1016/j.jhsg.2021.10.008
_version_ 1784599097163907072
author Earp, Brandon E.
Zhang, Dafang
Benavent, Kyra A.
Byrne, Laura
Blazar, Philip E.
author_facet Earp, Brandon E.
Zhang, Dafang
Benavent, Kyra A.
Byrne, Laura
Blazar, Philip E.
author_sort Earp, Brandon E.
collection PubMed
description PURPOSE: The impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) has been felt worldwide. We examined the quantitative impact during the first 4 weeks of hospital system and state-mandated restrictions on an academic, urban hand surgery practice. We hypothesized that the volume of clinic encounters, office procedures, and surgical cases would decrease and that the volume of nonelective care would remain unchanged. METHODS: We retrospectively reviewed all encounters at a hand surgery practice from March 16, 2020, through April 12, 2020 and compared those to two 4-week control time periods. Weekly encounter volumes and work relative value units (RVUs) were obtained for clinic encounters, office procedures, and surgical cases. The type of ambulatory visit was also identified. Surgical cases were categorized into 4 types (fracture or dislocation, acute soft tissue or nerve injury, infection, or elective/nonurgent) for the most recent time periods. We performed t tests to compare weekly volumes and RVUs between time periods. RESULTS: After the implementation of mandated restrictions on elective health care, ambulatory hand surgery clinic encounters decreased 72% to 73%, clinic procedures decreased by 87% to 90%, and surgical cases decreased by 87% to 88%. The percentage of ambulatory visits performed via telemedicine increased from 0.06% to 74%. Similar impacts on RVUs were seen. Surgeries for fractures and dislocations declined by 58% and those for acute soft tissue or nerve injury declined by 40%; the number of surgical procedures for infection remained unchanged. CONCLUSIONS: The coronavirus restrictions on elective healthcare led to an immediate, substantial impact on hand surgery practice. There were significant decreases in the volumes of ambulatory encounters, office procedures, and surgical cases. The long-term financial impact of this change in practice is still to be determined but, based on the quantitative impacts seen, is likely to be significant. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic/Decision Analysis IV.
format Online
Article
Text
id pubmed-8590933
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-85909332021-11-15 The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice Earp, Brandon E. Zhang, Dafang Benavent, Kyra A. Byrne, Laura Blazar, Philip E. J Hand Surg Glob Online Original Research PURPOSE: The impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) has been felt worldwide. We examined the quantitative impact during the first 4 weeks of hospital system and state-mandated restrictions on an academic, urban hand surgery practice. We hypothesized that the volume of clinic encounters, office procedures, and surgical cases would decrease and that the volume of nonelective care would remain unchanged. METHODS: We retrospectively reviewed all encounters at a hand surgery practice from March 16, 2020, through April 12, 2020 and compared those to two 4-week control time periods. Weekly encounter volumes and work relative value units (RVUs) were obtained for clinic encounters, office procedures, and surgical cases. The type of ambulatory visit was also identified. Surgical cases were categorized into 4 types (fracture or dislocation, acute soft tissue or nerve injury, infection, or elective/nonurgent) for the most recent time periods. We performed t tests to compare weekly volumes and RVUs between time periods. RESULTS: After the implementation of mandated restrictions on elective health care, ambulatory hand surgery clinic encounters decreased 72% to 73%, clinic procedures decreased by 87% to 90%, and surgical cases decreased by 87% to 88%. The percentage of ambulatory visits performed via telemedicine increased from 0.06% to 74%. Similar impacts on RVUs were seen. Surgeries for fractures and dislocations declined by 58% and those for acute soft tissue or nerve injury declined by 40%; the number of surgical procedures for infection remained unchanged. CONCLUSIONS: The coronavirus restrictions on elective healthcare led to an immediate, substantial impact on hand surgery practice. There were significant decreases in the volumes of ambulatory encounters, office procedures, and surgical cases. The long-term financial impact of this change in practice is still to be determined but, based on the quantitative impacts seen, is likely to be significant. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic/Decision Analysis IV. Elsevier 2021-11-15 /pmc/articles/PMC8590933/ /pubmed/34805806 http://dx.doi.org/10.1016/j.jhsg.2021.10.008 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Earp, Brandon E.
Zhang, Dafang
Benavent, Kyra A.
Byrne, Laura
Blazar, Philip E.
The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title_full The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title_fullStr The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title_full_unstemmed The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title_short The Impact of Coronavirus Disease 2019 Restrictions on an Academic Hand Surgery Practice
title_sort impact of coronavirus disease 2019 restrictions on an academic hand surgery practice
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590933/
https://www.ncbi.nlm.nih.gov/pubmed/34805806
http://dx.doi.org/10.1016/j.jhsg.2021.10.008
work_keys_str_mv AT earpbrandone theimpactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT zhangdafang theimpactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT benaventkyraa theimpactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT byrnelaura theimpactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT blazarphilipe theimpactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT earpbrandone impactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT zhangdafang impactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT benaventkyraa impactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT byrnelaura impactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice
AT blazarphilipe impactofcoronavirusdisease2019restrictionsonanacademichandsurgerypractice