新冠肺炎大流行早期美国医院选择性眼科手术量减少的影响。
Impact of reduced elective ophthalmic surgical volume on U.S. hospitals during the early coronavirus disease 2019 pandemic.
机构信息
From the Wilmer Eye Institute, The Johns Hopkins University School of Medicine (Fliotsos, Repka, Woreta, D. Srikumaran), Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine (Best, U. Srikumaran), Baltimore, Maryland, Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine (Field), Iowa City, Iowa, USA.
出版信息
J Cataract Refract Surg. 2021 Mar 1;47(3):345-351. doi: 10.1097/j.jcrs.0000000000000410.
PURPOSE
To estimate the financial impact of coronavirus disease 2019 (COVID-19)-related shutdowns on ophthalmic surgery performed at hospital outpatient departments (HOPDs) in the United States.
SETTING
Nationally representative sample of U.S. hospital payment and cost data.
DESIGN
Retrospective review and economic impact analysis.
METHODS
The Nationwide Ambulatory Surgery Sample (NASS) was used to identify ophthalmic surgical procedures and associated charges, which were performed at HOPDs. The highest volume elective ophthalmic procedures were identified. The total hospital cost and payment amount was calculated for each procedure using the Hospital Outpatient Prospective Payment System (OPPS) maintained by the Centers for Medicare & Medicaid Services. Net facility income (estimated payments less OPPS rates) was determined for each elective surgical procedure category and stratified by hospital teaching status.
RESULTS
In 2017, elective cataract, strabismus, and keratoplasty surgeries were performed 1 230 992 times at HOPDs. The total cost of these elective surgeries was 2350 million U.S. dollars (USD), with a total hospital payment of 3624 to 3786 million USD. This led to an estimated net income of 1278 to 1440 million USD overall to U.S. hospitals in the NASS dataset from elective ophthalmic surgery (approximately 107 to 120 million USD per month), with a larger proportion performed in teaching hospitals.
CONCLUSIONS
The cessation of elective ophthalmic surgeries at HOPDs during COVID-19 resulted in a significant loss of income for hospitals in the United States and teaching experiences for trainees at academic medical centers.
目的
估计 2019 年冠状病毒病（COVID-19）相关关闭对美国医院门诊部门（HOPD）进行的眼科手术的财务影响。
背景
美国医院支付和成本数据的全国代表性样本。
设计
回顾性审查和经济影响分析。
方法
使用全国门诊手术样本（NASS）来识别在 HOPD 进行的眼科手术程序和相关费用。确定了最高容量的选择性眼科手术。使用医疗保险和医疗补助服务中心维护的医院门诊预期付款系统（OPPS），为每个程序计算总医院成本和付款金额。对于每个选择性手术类别，根据医院教学地位确定净设施收入（估计付款减去 OPPS 费率）。
结果
2017 年，HOPD 共进行了 1230992 次选择性白内障、斜视和角膜移植手术。这些选择性手术的总成本为 2.35 亿美元，总医院支付额为 3.624 亿至 3.786 亿美元。这导致 NASS 数据集的美国医院整体估计净收入为 1.278 亿至 1.440 亿美元（每月约 1.07 亿至 1.20 亿美元），其中大部分在教学医院进行。
结论
COVID-19 期间 HOPD 选择性眼科手术的停止导致美国医院收入显著损失，学术医疗中心的受训者失去了教学经验。
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