Retrospective study in clinical governance and financing system impacts of the COVID-19 pandemic in the hand surgery and microsurgery HUB center.
COVID-19
Coronavirus
Epidemiology
Hand surgery
Telemedicine
Journal
Musculoskeletal surgery
ISSN: 2035-5114
Titre abrégé: Musculoskelet Surg
Pays: Italy
ID NLM: 101498346
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
14
08
2020
accepted:
22
01
2021
pubmed:
3
2
2021
medline:
23
8
2022
entrez:
2
2
2021
Statut:
ppublish
Résumé
The authors presented a retrospective study in the surgical activity of the HUB center for Hand Surgery and Microsurgery in Emilia-Romagna comparing the data between March and April 2020, in the peak of Covid pandemic, with the same period in 2019. During the two months period of March-April 2020 versus 2019 the authors analyzed the surgical procedures performed in elective and emergency surgery with hospitalization and Day or Outpatient surgery regime. Surgical treatments with no hospitalization were planned in the Day-Surgery Service. The financing system impacts were analyzed according to the Diagnosis Related Groups (DRG), the costs accounting method mostly used in European countries. An overall reduction of 68.5% was recorded in surgical procedures, with a more relevant reduction of 92.3% in elective surgery and a significantly less relevant reduction of 37.2% in urgent one. Replantation did not present a reduction in number of cases, while cutting lesions of tendons at the hand and fingers increased such as the bone and ligament injuries during domestic accidents. The negative impact in the financial system recorded a reduction of 32.5%. The epidemiology of hand trauma looks not only at the artisanal and industrial injuries, but also mostly at the accidents in daily life activities. The data of the study evidenced the significantly increase in the injuries occurring in the domestic environment. Elective surgery was canceled. The 86% of surgical procedures performed were urgent ones and the 72.8% of these were possible in Day and Outpatient surgery with significantly reduction in hospitalization. All procedures followed a rigid process for patient and healthcare workers with regard for personal protection and safety. Telemedicine was arranged in emergencies, and economic damage was analyzed also in the following rebound effect during summer period. The significantly less reduction recorded in urgent surgery vs the more relevant reduction in elective one showed how the hand injuries remained a major issue also during the lockdown. The data highlighted the relevant role of the organizational aspects of the surgical procedures and planning in hand trauma. Despite the financial impact of the elective surgery, the presence of a functional and skill Emergency Service and Day-Surgery Service resulted fundamental in the efficacy and efficiency of the patient management and in containment of economic damage. The telemedicine was significantly limited by liability and risk management issues.
Identifiants
pubmed: 33528801
doi: 10.1007/s12306-021-00700-3
pii: 10.1007/s12306-021-00700-3
pmc: PMC7851813
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
291-296Informations de copyright
© 2021. Istituto Ortopedico Rizzoli.
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