TY - JOUR
T1 - SARS-CoV-2 Impact on Elective Orthopaedic Surgery
T2 - Implications for Post-Pandemic Recovery
AU - Jain, Amit
AU - Jain, Punya
AU - Aggarwal, Shruti
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background:The aim of our study was to explore the impact of elective-surgery deferment on the United States health-care system and subsequent recovery after COVID-19 containment. Using an orthopaedic elective surgery model, we aimed to answer the following: (1) What is the expected recovery time until the health-care system is back to nearly full capacity for performing elective surgery? (2) What will be the expected backlog of elective surgery over time? (3) How should health care change to address the backlog?Methods:A Monte Carlo stochastic simulation-based analysis was performed to forecast the post-pandemic volume of elective, inpatient total joint arthroplasty and spinal fusion surgical cases. The cumulative backlog was calculated and analyzed. We tested model assumptions with sensitivity analyses.Results:Assuming that elective orthopaedic surgery resumes in June 2020, it will take 7, 12, and 16 months - in optimistic, ambivalent, and pessimistic scenarios, respectively - until the health-care system can perform 90% of the expected pre-pandemic forecasted volume of surgery. In the optimistic scenario, there will be a cumulative backlog of >1 million surgical cases at 2 years after the end of elective-surgery deferment.Conclusions:The deferment of elective surgical cases during the SARS-CoV-2 pandemic will have a lasting impact on the United States health-care system. As part of disaster mitigation, it is critical to start planning for recovery now.
AB - Background:The aim of our study was to explore the impact of elective-surgery deferment on the United States health-care system and subsequent recovery after COVID-19 containment. Using an orthopaedic elective surgery model, we aimed to answer the following: (1) What is the expected recovery time until the health-care system is back to nearly full capacity for performing elective surgery? (2) What will be the expected backlog of elective surgery over time? (3) How should health care change to address the backlog?Methods:A Monte Carlo stochastic simulation-based analysis was performed to forecast the post-pandemic volume of elective, inpatient total joint arthroplasty and spinal fusion surgical cases. The cumulative backlog was calculated and analyzed. We tested model assumptions with sensitivity analyses.Results:Assuming that elective orthopaedic surgery resumes in June 2020, it will take 7, 12, and 16 months - in optimistic, ambivalent, and pessimistic scenarios, respectively - until the health-care system can perform 90% of the expected pre-pandemic forecasted volume of surgery. In the optimistic scenario, there will be a cumulative backlog of >1 million surgical cases at 2 years after the end of elective-surgery deferment.Conclusions:The deferment of elective surgical cases during the SARS-CoV-2 pandemic will have a lasting impact on the United States health-care system. As part of disaster mitigation, it is critical to start planning for recovery now.
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U2 - 10.2106/JBJS.20.00602
DO - 10.2106/JBJS.20.00602
M3 - Article
C2 - 32618916
AN - SCOPUS:85085311969
SN - 0021-9355
VL - 102
SP - E68
JO - Journal of Bone and Joint Surgery
JF - Journal of Bone and Joint Surgery
IS - 13
ER -