Earp Brandon E, Zhang Dafang, Benavent Kyra A, Byrne Laura, Blazar Philip E
Orthopedics. 2020 Jul 1;43(4):228-232. doi: 10.3928/01477447-20200624-03.
The SARS-CoV-2 (COVID-19) pandemic has had a global influence on health care. The authors examined the early effect of hospital- and state-mandated restrictions on an orthopedic surgery department and hypothesized that the volume of ambulatory clinic encounters, office and surgical procedures, and cases would dramatically decrease. A retrospective review was performed of all encounters in an orthopedic surgery department at a level I academic trauma center during a 4-week period, from March 16, 2020, to April 12, 2020. The results were compared with two control 4-week periods, February 17, 2020, to March 15, 2020, and March 16, 2019, to April 12, 2019. Weekly volume and work relative value units (RVUs) of clinic encounters, office and surgical procedures, and cases were assessed. The type of ambulatory visit also was recorded. Comparisons of mean weekly volume and RVUs between the study and control periods were performed with Student's t test. Surgical cases were categorized into fracture or dislocation, acute soft tissue or nerve injury, infection, oncology, and elective or nonurgent. After implementation of hospital- and state-mandated restrictions on elective health care, the volume of ambulatory orthopedic surgery clinic encounters decreased by 74% to 77%, the volume of clinic procedures decreased by 95%, and the volume of surgical cases decreased by 88%. The percentage of clinic visits performed via telemedicine increased from 0.3% to 81.2%. Elective surgical cases ceased, and the volume of nonelective surgical cases decreased by 51%. During the first 4 weeks after COVID-19-related restrictions were imposed, an immediate and dramatic effect was observed. Compared with the control periods, significant reductions were seen in the volume of ambulatory encounters, office-based procedures, and surgical cases. In addition, the volume of nonelective surgical cases decreased by 51%. [Orthopedics. 2020;43(4):228-232.].
严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒）大流行对医疗保健产生了全球性影响。作者研究了医院和州政府强制实施的限制措施对一个骨科手术科室的早期影响，并假设门诊诊疗、办公室及外科手术量和病例数将大幅下降。对一家一级学术创伤中心骨科手术科室在2020年3月16日至2020年4月12日这4周内的所有诊疗情况进行了回顾性研究。将结果与两个对照的4周时间段进行比较，即2020年2月17日至2020年3月15日以及2019年3月16日至2019年4月12日。评估了门诊诊疗、办公室及外科手术的每周量和工作相对价值单位（RVUs），并记录了门诊就诊类型。采用学生t检验对研究期和对照期的平均每周量和RVUs进行比较。外科病例分为骨折或脱位、急性软组织或神经损伤、感染、肿瘤以及择期或非紧急情况。在医院和州政府对择期医疗保健实施强制限制措施后，骨科门诊手术诊疗量下降了74%至77%，门诊手术量下降了95%，外科病例数下降了88%。通过远程医疗进行的门诊就诊百分比从0.3%增至81.2%。择期外科病例停止，非择期外科病例数下降了51%。在实施与新冠病毒相关的限制措施后的头4周内，观察到了即时且显著的影响。与对照期相比，门诊诊疗量、基于办公室的手术量和外科病例数均显著减少。此外，非择期外科病例数下降了51%。[《骨科》。2020年；43(4):228 - 232。]
